Media Release

Sarah hopes to inspire confidence in others by sharing her decision to Live Flat

A Hunstanton woman, who underwent a double mastectomy following breast cancer, is sharing the reasons behind her decision to “Live Flat”.

Sarah Coombes discovered a lump in her right breast just days before her 35th birthday which was found to be a Grade III invasive tumour.

Sarah asked for a double mastectomy in order to have an even chest and was treated by the team at the West Norfolk Breast Cancer Unit at The Queen Elizabeth Hospital

Following her surgery, Sarah decided not to have reconstructive surgery and is sharing her story to inspire others.

Breast Cancer remains one of the most common cancers in the UK but survival rates have doubled in 40 years thanks to more awareness, a screening prevention programme and treatment advancements.


Women also now have a wider choice of options to ensure that they can move on from their cancer with greater body confidence, with some preferring to have reconstructive surgery while others decide not to.

Sarah said: “I have a very strong gut instinct and I didn’t want to have reconstructive surgery as I felt comfortable with my chest. I think it is important for women to feel confident and comfortable with who they are.

“I felt I needed to have the mastectomy as I had cancer but I didn’t want any further operations.

“I am probably more confident now as I can be myself now. I respect anyone’s decision to have reconstruction as I am aware it is up to the individual but I also wanted to share my decision not to have surgery and that it can be positive.”

Sarah does not have a family history of breast cancer. After discovering the lump, Sarah visited her GP who later referred her to the Breast Care team at the QEH.

The team conducted a mammogram, an ultrasound scan and a biopsy which revealed that Sarah had cancer.

Sarah said: “It was a complete shock. The lump took up most of my breast and there would not be much left behind.

“In my head the problem was that I had cancer in my breast so the obvious solution was to remove it. There was a small bit of me that thought that I didn’t need breasts to be a valuable human being. They didn’t define me.”

The Hospital’s Consultant Oncoplastic Breast Surgeon Amy Burger conducted a double mastectomy for Sarah in January 2015.

Sarah said: My scars are quite beautiful as they are symmetrical and neat and run in a curve line near my ribs.

“Having seen pictures of other mastectomy scars, I think Miss Burger has done a beautiful job.”

This was followed by six rounds of chemotherapy between March and June 2015.

Sarah said: “Chemotherapy was horrible and I would not wish that on anyone but there is no way around it.”

Treatment has worked and Sarah is now showing no signs of disease. She is moving forward by writing a blog, which includes fashion advice, to help give confidence to other women after their mastectomies.

Sarah, who is a trustee of Flat Friends  charity support group, said: “My blog has gone really well. I didn’t want anyone else searching for post mastectomy confidence if I could help.

“I have always wanted the blog to be about women finding the confidence to try on different styles and get used to a new body shape.

“I have found that pleated materials and gathered necklines add volume and movement across the chest. There are a lot of different styles that work.”

Patient preference and the clinical situation are among the factors which are taken into account when deciding a treatment plan, if this is suitable for their particular care.

Some people prefer to opt for a lumpectomy, in which only the lump and surrounding tissue is removed, as opposed to a mastectomy.

Consultant Oncoplastic Breast Surgeon Miss Burger works with hundreds of patients each year to decide what their treatment options should be.

She said: “Some patients do have a preference of whether they would prefer a lumpectomy or a mastectomy but this is something we discuss in detail with patients.

“The choice to remove a normal breast is a huge undertaking and not something we would routinely suggest. There is no evidence that it improves people’s outcomes but we understand that it gives peace of mind to some patients and we do not underestimate the importance of that.”

Mastectomies are a relatively straight forward and low risk operation, which can take an hour or more to complete on one side.

Miss Burger is keen to ensure that patients are left with the best aesthetic outcome as possible.

She said: “I do leave a curved scar rather than a straight scar as I think the patient appreciates that the body doesn’t have straight lines.

“As much with reconstruction operations I want to make sure that the patient has the best results that I can create. If you are leaving someone with a flat chest it needs to be smooth to give them the opportunity to wear an external prosthesis or simply feel comfortable to wear whatever they wish.

“I am pleased that Sarah is happy with her outcomes: she has done brilliantly with her Flat Friends Support Group and offering support to women who chose that this is the way forward for them instead of reconstruction.”


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