
NPOAS represented FLAT the last week of April 2022 at the Oncology Nursing Society ‘s 2022 Congress! Huge thanks to lead volunteer Renee Ridgeley (@LessThanTwoBreasts & the voice of Dr. Wendy Sage, the first openly single breasted TV character) for organizing and staffing our exhibit, and to all of our volunteers who staffed the booth. Here’s a report from Renee!
Not Putting On A Shirt took aesthetic flat closure (AFC) awareness and education to the Oncology Nurses Society (ONC) 2022 conference. Following their success at the American Society of Breast Surgeons (ASBrS) conference earlier this year, NPOAS was encouraged by ASBrS attendees to have a presence at ONS where over 2,600 oncology nurses, patient navigators and other medical providers gathered for the in-person conference in Anaheim, California, April 28 to May 1.
Six breast cancer patient advocates and one patient caregiver volunteered to work at the NPOAS booth which was located in the nonprofit Advocates corridor of Exhibitors Hall. These seven women engaged over 300 medical professionals over the course of three days. Conference attendees engaging with the NPOAS booth were able to:
- learn about NPOAS’s work with breast and plastic surgeons to ensure optimal surgical outcomes for women who choose to go flat after mastectomy
- view testimonial videos of patients who chose AFC
- talk with advocates who shared their experiences
- submit their practice for the NPOAS Surgeons Directory for AFC and Goldilocks mastectomy
- register their breast clinics to receive My Choice AFC educational brochures for patient distribution (offered free of charge in English and Spanish by NPOAS)
NPOAS advocates distributed over 300 NPOAS brochures (with information and links to the NPOAS website) and over 400 My Choice AFC educational brochures (a literary supplement to a patient’s surgical consultation). Several nurses and navigators requested 20-30 patient brochures for immediate use at their clinics. NPOAS continues to ship orders from attendees of both American Society of Breast Surgeons and ONS conferences.

Many nurses who had experienced breast cancer themselves shared personal stories of breast cancer surgery with the NPOAS advocates. Nurses with implants, tissue-based reconstruction and flat closure were candid about their experiences. Several nurses with reconstruction reported decision regret due to lack of information about collateral damage of reconstruction. Other nurses reported that AFC would be their choice if ever faced with a breast cancer diagnosis.
A few patient/nurses reported being shamed by surgeons for choosing not to reconstruct breast mounds. One young nurse, in her 20s at the time, went against her doctor’s wishes and demanded that her expanders be removed permanently, and that she be closed flat after being admitted to the hospital for life-threatening infections. Another oncology nurse in her 30s was repeatedly questioned for choosing not to reconstruct. In the hospital just before mastectomy, her surgeon again challenged her decision to go flat “with an eyeball roll”, then warned her that she would have long scars. The woman (of average BMI with B-cup native breasts) woke from anesthesia to find her incisions extended from the top of her biceps through the axilla, across her chest and then down to her waist. The nurse reported that this was not an optimal outcome.




Nurses and patient navigators shared with advocates their enthusiasm for AFC awareness, with many noting their practice was supportive and competent in providing AFC. Some attendees expressed frustration with the lack of institutional patient education material available for women choosing flat. Some nurses reported that the surgeons they work with do not support flat and actively dissuade women from their option to go flat. Many took NPOAS and My Choice AFC brochures back to these surgeons.
These stories as well as the warm reception from all the attendees who engaged with the NPOAS booth, were confirmation of the important and necessary work provided by NPOAS.