The patient had just undergone a double mastectomy for breast cancer when Dr. Rina Gitler met her in Guerrero, Mexico. And she was crying.
The patient didn’t speak Spanish, only her Indigenous Nahuatl language. She had not realized that the procedure would mean that she was “going out flat,” or with her breasts completely removed, said Gitler, a breast reconstruction surgeon and founder of the ALMA Foundation.
The ALMA Foundation is a group of plastic surgeons who specialize in breast reconstruction and perform reconstructive surgeries at no cost to breast cancer survivors.
Gitler spoke with the patient through a translator and told her about the option of having reconstructive surgery. Soon thereafter, the patient became a candidate and received a reconstruction from Gitler’s team of volunteer surgeons.
In 2020, Mexico saw more than 29,000 new cases of breast cancer and almost 8,000 related deaths, making it the most common cancer among Mexican women, according to the WHO. Treating the disease with a multidisciplinary medical team that includes an oncologist, mental health provider, and plastic surgeon is an important priority.
For many women, reconstructive surgery is an essential part of their recovery. But it’s generally not covered by public insurance, and many individuals can’t afford the procedure.
Direct Relief has provided ongoing support to two organizations in Mexico that work with breast cancer survivors: Fundación Alma, and Fundación Voluntarias Contra el Cáncer, which helps women with high economic vulnerability navigate breast cancer treatment and connect them to services.
Both organizations offer services free of charge, including helping a total of more than 800 women thus far access reconstructive surgery at Mexican hospitals.
Now, the company Johnson & Johnson Mexico has added its support, making it possible for Fundación Alma and Fundación Voluntarias Contra el Cáncer to help more women.
“It is extremely important to support women to feel comfortable with themselves, providing information that helps them develop the confidence to self-examine, as well as to know and explore comprehensive breast cancer treatment options, including breast reconstruction,” a Johnson & Johnson press release said.
Of course, reconstructive breast surgery isn’t for everyone.
“[Reconstruction] is entirely the patient’s decision,” said Esther Cisneros, the President of Fundación Voluntarias contra el Cáncer A.C., an organization that helps women navigate breast cancer treatment and connect them with free reconstructive surgeries. “What the foundation seeks is that the patient always has the option regardless of what they decide.”
But when presented with the option, an overwhelming majority of women in Mexico —more than two-thirds—said they’d prefer to have breast reconstruction after their mastectomy. “There are many studies that if you inform patients about the procedure, you…increase the uptake of the surgery by 30%,” said Paulina Bajonero, a researcher and general surgeon in Monterrey, Mexico.
Many women report feeling less confident after surviving breast cancer and according to Bajonero’s research, just want “to look the same as they did before.”
Gitler, who is also a breast cancer survivor, said seeing her body after her double mastectomy was “one of the most shocking moments” of her life. Now, when she counsels patients at the ALMA Foundation, she understands why having breasts can be an important part of a woman’s identity. “The phrase I hear every day is that they ‘feel incomplete,’” she said.
Additionally, some women face fallout in their romantic relationships after having breast cancer surgery. “Sadly in Mexico there is still this thought [among] men that…women are worthy because of their breasts,” said Gitler. Sixty percent of patients at the ALMA Foundation report being left by their partners after their diagnosis.
For many women, receiving reconstructive surgery is an important part of resuming their social and professional lives. But it’s not just about reducing or erasing the negative consequences of breast cancer surgery. Instead, it’s often about moving on.
“Reconstruction makes it so [women] can close a window,” said Cisneros, allowing them to put their experience with cancer behind them.
Direct Relief has provided more than $260,000 in medical aid to Fundación Alma and Fundación Voluntarias Contra el Cáncer. Johnson & Johnson Mexico provided breast implants for patients receiving reconstructive surgery through these two organizations.
