Apr 26 2004

EXCLUSIVE

By Patrick Hill

IT was the picture that thrust the taboo subject of mastectomy into the public's consciousness.

Just eight months after having her cancerous breast removed, actress Amanda Mealing posed topless to show the world her "battle scars".

The picture seemed to tell the world the worst was over and that she was no less of a woman for her operation.

But then, less than a year later, Amanda almost died while undergoing reconstructive surgery.

"During the operation they had real problems re-connecting my blood vessels using microsurgery," she says. "It took them an extra five hours - and, yes, I could have died.

"I knew there was a risk - my surgeon went to great lengths to point that out but, for me, I felt it was worth it.

"It's not that I think I'm any more of a woman now - in fact it's not that different from wearing a prosthetic piece. It weighs the same and there's no feeling.

"But if the operation had failed, I'd already decided to go for another one and another one after that. I felt that my whole treatment would have been incomplete without attempting it, like taking driving lessons and never taking your test."

Amanda, 36, made her name in TV shows like Jake's Progress, GBH and The Grand and was one of Hugh Grant's ex-girlfriends in the 1994 film Four Weddings And A Funeral.

Now she is set to return to the screen in the BBC1 medical drama Holby City this June. As the hospital's new clinical director, she will bed a string of men in the some of the show's steamiest plot lines.

It's all a very far cry from the heartbreak which began in August 2002 when, while seven months pregnant with her second son, Otis, she discovered a pea-sized lump in her right breast.

At first she ignored it, blaming mastitis but then, on the day she gave birth in October 2002, she discovered the lump had grown to the size of an egg.

Two weeks later she was back in hospital for a mastectomy with husband, writer Richard Sainsbury, by her side.

"The worst time was the two weeks leading up to the operation. It was the most horrendous time of my life," she says.

"A couple of times I woke up at night, sobbing. I was thinking: 'How much of my sons' lives am I going to see? Will I ever see Otis's birthday?' It's impossible not to think like that.

"I practised saying my farewells to my children so many times and I've lived the last year like that.

"But most of the time I didn't rage. I was quite numb, but also resigned. I could see from the very start how big the tumour was and it was just a case of dealing with it.

"I took it a day at a time and I found out as much as I could about the surgery.

"As a woman under 60 with breast cancer I felt under-represented because I thought this was something that only affected older women. In fact some 20 per cent of the women diagnosed every year are under 50.

"When I came round from the operation, I looked down. It was hard to take in at first, but I had tried very hard the night before to visualise the whole thing.

I asked Richard if he wanted to have a look because he had to get used to it. He said: 'I really don't care.'

"He has been so wonderful throughout. More than anyone else, he has reminded me that I am no less a woman because I have lost a breast.

"You can't help but think about it, but I never dwelt on it. My husband said to me: 'Your breast isn't you. It's just a lump of fatty tissue.'"

ALTHOUGH the two-hour operation to remove her breast was a success, Amanda then had to endure eight months of chemo- and radiotherapy.

She completed the course in June, 2003 and will have a-check-up once a year for the next five years.

"I think the chemotherapy just on its own is an endurance test and my greatest achievement each day was just to get through it and not be too sick," says Amanda, who lives near Stamford, Lincs, with Richard and sons Milo, four, and Otis, 18 months.

"It's like having food poisoning that can go on for months. It's a physical endurance test at the same time as a mental one because you are battling for your life."

She had reconstructive surgery at Middlesex Hospital in Central London last September.

The operation involved the use of a specialised technique that removes flesh from the stomach before it's grafted to the breast area.

Each blood vessel must be closed and reattached to the new area in a process that's meant to last six hours. In the end, it took 11 hours.

"Reconstruction had always been part of my plan right from the early diagnosis.

"At that point I still had two breasts and that seemed to be the perfect blueprint.

"I clung on to that plan because it was important for me to know that I was going to be back to the person that I was. I didn't do it because of vanity although some people will say that's the reason." With a smile, she adds: "I had an irate message from one viewer who heard about my operation on television.

"She said, 'It's fine if you can afford it' but the truth is my operation was funded by the NHS.

"Unfortunately so many women are left ignorant of the options - often even their GPs are unaware of what can be offered.

"Some areas of the country may not be able to provide such services, while there are women who will not be suited to the kind of operation I underwent.

"But I'm passionate that more women should be aware of the choices available to them."

Amanda's determination led to her being chosen to head the Boots Breast Cancer Be Up Front campaign last year.

It aimed to promote awareness of the disease, which strikes 40,000 women in Britain every year, and warns that early diagnosis is the key to successful recovery.

Today, Amanda is still a passionate campaigner for the Breast Cancer Care charity and is rightly proud of stripping off after her breast was removed. As she says: "If by daring to show what I had to undergo actually helped save the life of one woman or inspired others to proceed with that kind of treatment, then it will have been worth it.

"I'm sure that someone somewhere will feel betrayed after having seen me stand up for the first time and publicly show my mastectomy scar but I'm still proud of what I did. I'm proud of my battle scar - but it doesn't make me who I am.

"I want women to see what they can actually look like after such an operation.

"But I have found there's so much ignorance among women, who have suffered in similar ways, about what options are available and what kind of reconstructive surgery can be offered to them.

THE cancer has taught me that I'm tougher than I thought and made me realise what's important in life.

"Before I was ill, if I was late for something then I'd panic. Now, if I find myself running late, I say 'So what? - I'll simply phone up and explain and apologise.'

"If you're going to be late, then you're going to be late - there's no point in worrying about it.

"These days I've a good approach to things. I take everything just for what it is and keep things in proportion."

"Having the reconstruction meant that I could get back to wearing more glamorous and revealing clothes.

"But for me it finishes here - I need to have that kind of closure on this period of my life. I have to put a full stop down so I can close that chapter in my life and walk away from it.

"Winning my role in Holby couldn't have been better. It's a fantastic role, although it is very demanding and means a lot of hard work, spending lots of time from my family.

"People have been so supportive of me and now I'm really enjoying life and my work - and let's face it, no one has better experience of an operating theatre.

"This has been my journey, throughout which I've been tested to the limit. But at the end of it all I feel that I've learned a few things about life and myself. They've cut things away from me and I've been invaded by the most vile things.

"But now, with the reconstruction, I feel that the risk was worth taking - even if the whole exercise makes you realise just how fragile life is."