Why Kate chose to 'stay flat' after breast cancer surgery

Kate Miller loves to garden topless.

"It is just so liberating, and it's so nice at dusk," says the 39-year-old from the Lockyer Valley/land of the Yuggera and Ugarapul people in Queensland.

"A bee or a butterfly or something lands on my chest and it's just this beautiful moment of clarity that I made the right decision."

That decision was to have a double mastectomy after being diagnosed with breast cancer aged 37.

Every year in Australia, about 20,000 women will be diagnosed with breast cancer.

Of those, about 40 per cent will need a mastectomy — surgery to remove the breast.

Almost a third of women who have a mastectomy will choose to have some kind of reconstruction.

Kate opted to "stay flat" and says "it was like a weight was lifted off my shoulders — no pun intended."

ABC podcast Ladies, We Need to Talk spoke with Kate about her decision to remove both her breasts.

These are her words.

My doctor was horrified

My doctor recommended a mastectomy on one side only, but I wanted both breasts gone.

One of the things my doctor said to me was, "If you meet someone in the future and you no longer have breasts, how will you feel if that's the barrier to you having a relationship with them?"

The other thing she said to me was, "What if you change your mind about having kids?"

I made a decision a long time ago. I didn't want children.

I thought, this body part has betrayed me. I don't want to sit here and worry for the rest of my life that it's going to betray me again.

That it's going to come back.

When moving from the private system to a public hospital for treatment, the surgeons were all male.

They never questioned my decision.

I didn't need a rationale for them. They just said, "Yeah, sure. No worries. It's your body."

Reconstruction would hold me back

I had already made a decision that reconstruction wasn't for me.

In part because of all the things that I wanted to be able to do. Recon just would've been a barrier or made those things harder.

I love horse riding and swimming, and I didn't want more medical procedures than I was already having.

Before my double mastectomy, I had very big breasts. A double D or an E … they were a bit annoying.

And I used to joke that I would just put a [bra] cup on my head, and if it fit my head, it would fit my boobs.

That was how I bought bras.

After my diagnosis I couldn't look at them. I was building a tiny house and decided not to install mirrors that whole time.

I just didn't want to look at my body.

And so, the moment that they sat me in the bed in pre-op … I knew I was going to get what I needed to feel safe moving forward in my life.

I found a theme song for myself that I then used to sort of hype myself up before I looked at my chest after they took the bandages off.

It was that song from The Greatest Showman: This Is Me.

This thing that had made me feel like I needed to make myself smaller was now gone.

I was walking into a new version of myself and a version that had cut away the cancerous, sick, harmful, murderous part of my body.

How it feels to be flat

There was an incident going into work one day. I commute on the train and there was a younger couple sitting across from me. And the guy turns to his girlfriend and says, "Is that an it?"

I was never this gutsy before cancer, but since cancer, it's just like, seriously, who gives a shit? Just speak your mind.

I stood up and I said, "Not that it actually matters, but I've lost my boobs to breast cancer", and I got off the train and that was it.

I actually installed wardrobes a couple of months ago with sliding mirrors on the doors. And I don't hate looking at my reflection anymore.

My chest isn't perfect. It doesn't look the way that I thought it would look when I decided to have a mastectomy.

There's little bits of skin leftover because I didn't go with an aesthetic closure, which is where the plastic surgeons come in and sort of make it look a bit pretty.

But at the end of the day, I look at every single scar, every single little bit of skin left over, and I think to myself, "You've fought a battle, Kate … this is the way that your body looks and just embrace her and take care of her.

"Nurture her and nourish her, because she's got you through all of this."