How breast cancer forced this flight attendant, 34, to confront her identity and body image
Ms Chuah Yi Fang was shocked at how much she was affected by a breast mastectomy and reconstruction but has come through the experience with renewed enthusiasm for her career and life.
Ms Chuah Yi Fang (pictured) was diagnosed with breast cancer in January 2023. (Photo: CNA/Nuria Ling)
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These days, I give myself only a brief glance in the mirror – partly because life demands attention elsewhere, but also as a way to avoid dwelling on flaws.
A colleague introduced me to "body neutrality" – a concept that suggests a neutral stance towards one's appearance, rather than the celebration encouraged by body positivity.
Neither loving nor hating your body sounded more attainable, but still easier said than done.
But my shaky confidence and strategy to avoid thinking too much about my body seemed fragile when I considered what it might be like to confront changes to my body outside my control.
This is a challenge that flight attendant Chuah Yi Fang faced head on in the aftermath of her early breast cancer diagnosis in January 2023.
More than the initial shock of getting this diagnosis at a young age, Ms Chuah said that the recovery period after her mastectomy and breast reconstruction was the “toughest part of (her) life”.
The 34-year-old said: “Looking in the mirror was painful – I felt like I had lost a part of my identity as a woman.”
Sitting across from her in her home earlier in October – during Breast Cancer Awareness Month – she candidly shared how this journey forced her to confront her relationship with her body in ways that she had never imagined.
The seasoned flight attendant has since returned to her hectic routine, taking to the skies so frequently that scheduling our interview took some effort.
Despite this, Ms Chuah made time to sit down with me, speaking calmly even as I enquired about the deeply personal challenges of accepting her new body after her diagnosis and treatment.
When I asked why she has decided to open up about her story now, she said that she did not want other young women to be complacent or afraid of regular checkups for breast cancer, because early detection can make “all the difference”.
Clinical Assistant Professor Tira Tan said that Ms Chuah was diagnosed with the most common subtype of breast cancer.
One in six breast cancer cases diagnosed yearly in Singapore involves women under 40.
Clin Asst Prof Tan, who is a senior consultant in the department of breast and gynaecology at the National Cancer Centre Singapore, noted that some younger women are diagnosed at later stages of the disease, since they fall outside the recommended age for routine cancer screenings.
The advice most women are familiar with is to go for a mammogram every two years if they are aged 50 and above.
“Many young women feel that they are healthy and do not regularly see their primary care providers.
"Additionally, younger women prioritise many other aspects of their lives including career, their young families and social activities, which can delay responses to concerning health issues,” Clin Asst Prof Tan added.
A BODY THAT NO LONGER 'FELT LIKE HER OWN'
For Ms Chuah, her initial diagnosis was not overly worrying, since breast cancer and the possibility of a mastectomy was not a foreign concept. Her mother had received the same diagnosis and also went for a mastectomy when she was 45, when Ms Chuah was eight years old.
Given her family history and noticing that her breasts felt “unusually lumpy”, Ms Chuah started going for yearly ultrasound scans with a general practitioner in her early 20s.
For years, doctors found nothing amiss. When the Covid-19 pandemic hit, she skipped two annual ultrasound scans only to find out in 2022 after a checkup that the lumps in her breast had grown.
Even then, her doctor reassured her that it was unlikely to be cancer given her young age, but referred her to a specialist anyway for more checks.
She did a mammogram and an ultrasound scan of her breasts, followed by a biopsy, which confirmed the diagnosis of breast cancer.
Her treating doctor, Associate Professor Yong Wei Sean from Singapore General Hospital and National Cancer Centre Singapore, said that a mastectomy was recommended for Ms Chuah given that she had multiple suspicious lumps and the procedure would ensure no cancer cells were left behind.
Ms Chuah was also offered the option of having breast reconstruction following the mastectomy, to which she agreed.
Assoc Prof Yong, who is a senior consultant, said that breast reconstruction is important for the appearance and emotional well-being of patients.
Although she was somewhat familiar with the surgical process as a child after watching her mother’s diagnosis, treatment and recovery, Ms Chuah said that she “underestimated” how much she would be affected by the process.
In February last year, after 12 hours of surgery under general anaesthesia, she woke up with scars, tubes connected to wounds and a body that “no longer felt like (her) own”.
In addition to removing one of her breasts, the doctors also removed six lymph nodes surrounding the area.
Since she opted for a breast reconstruction that used her own flesh rather than implants, Ms Chuah also had dressings and bandages applied over incisions made from her thighs where doctors had removed sections to use in the reconstructed breast.
GRAPPLING WITH BODY IMAGE, ISOLATION
Even though her family is no stranger to breast cancer, Ms Chuah told her family members about her diagnosis after a treatment plan was in place, because she did not want her mother to worry. Her mother lives in Penang, Malaysia.
Ms Chuah, who is a Singapore permanent resident, urged her family not to come to Singapore, since she felt she would be unable to host them while she was recovering.
Her husband, who is also a flight attendant, took two weeks off work to accompany her in the hospital.
He eventually returned to work once she was discharged, but made an effort to change his flights whenever possible to be with her as much as he could.
Over the next nine months, she spent most of her time at home alone.
Staying at home was mostly to help her recover, but at times, it was a choice she made because she felt self-conscious about her body and how others would look at her.
"After the surgery, I felt very low in self-esteem, like I was so different from other people," she said, adding that that entire period of recovery was "isolating". She had problems looking at herself in the mirror, unable to face the scars as a result of the surgery and a body that did not felt like her own.
Ms Chuah had doubts several times about going back to what was always her "dream job", knowing full well that for cabin crew, it is "all about image" and they would require confidence and composure, both attributes she felt she was lacking after surgery.
Having always kept long hair, she decided to cut it short after her diagnosis, in anticipation that she might need chemotherapy like many others, though tests after her surgery revealed that her type of cancer does not respond to this treatment.
Keeping her hair short felt like the right choice, however, since she was not able to wash her hair for a while after surgery and was reluctant to face the "emotional challenge" of cutting it again if more treatment was needed.
"With my hair cut short, I felt like I had lost a part of my femininity, and I worried that I resembled a boy or looked too masculine, especially in my stewardess uniform," she said.
Fearing that people might think that she was not as polished or professional as before, there were even times when she was almost afraid to speak to others out of fear of being judged as "the stewardess who looks different".
Aside from making trips to the hospital for follow-up reviews, she spent more time at home during her recovery period because it felt like a "safe space", with her new pet puppy that was a great comfort and distraction when her husband was away.
“Whether it's getting a puppy or reconnecting with things that bring you joy, every small decision adds up to a meaningful life.”Ms Chuah Yi Fang, on her experience recovering from breast cancer
"I did think of other options, like having a ground job or being a baker," Ms Chuah said with a chuckle about her time in recovery.
With the support of family and close friends, she put those thoughts aside and decided that she would stick it out for a few more years, even if it was initially daunting to return to the skies in October last year.
"I wasn't prepared to go back, but I thought, every day, sitting down there (at home), I'm not going to (progress) any further. So I told myself, I still have a life to live, I should do something."
APPRECIATING EVERY MOMENT UP IN THE SKY
Starting work after a long break was not without some turbulence.
On the practical challenges of the job, Ms Chuah said that she had to undergo re-training to renew expired licences required for her role.
The surgery also made certain simple tasks such as reaching up to close an overhead compartment more challenging with one arm feeling slightly shorter.
“I was once very confident. I knew inside out what was going on (in my work), but going back was tough. I felt like I was not as good as I was before or as good as others.”
Then, she had to handle interacting with colleagues after an extended period.
"When colleagues ask, 'Why did you go on (sick leave) for so long or why are you not flying', they weren't prepared for (breast cancer) as an answer ... Most people don't know how to respond, so I don't want to put them in that (position) either."
She added that the airline company where she works preferred to remain anonymous for this article.
Even though she was initially concerned about her first flight back on the job, Ms Chuah, who could not recall the destination of that flight, remembered that joy was the overriding emotion.
Before her cancer diagnosis, she had worked for a decade without ever taking a single day of sick leave.
Even after the call from her doctor breaking the news of her diagnosis, she recalled being reluctant to pull out of a scheduled work flight to London in England hours later.
"Going back, flying, I look at the job differently than before. I did that for 14 years, so I was a bit jaded, but now I appreciate every moment, every flight, I try to enjoy it," she said.
Ms Chuah will not have to undergo chemotherapy but will be on oral hormonal therapy, which blocks the female hormone estrogen or lowers estrogen levels, for the next 10 years.
Being on this hormonal treatment accelerated the couple's family planning discussions and they went for fertility counselling to understand how it might affect her ability to have children and if they should start the process for in-vitro fertilisation (IVF) before beginning the medication.
After much deliberation, the couple have decided not to try to conceive through IVF.
Additionally, a genetic test indicated that her form of breast cancer was not hereditary, but Ms Chuah remained cautious about her family's history with the disease and did not want to risk passing it on to her children.
Despite her diagnosis turning her whole life “upside down” and making previous plans for career and family seem remote, Ms Chuah said that the experience gave her a new lease on life.
She witnessed the unwavering support of her family and the couple’s spontaneous decision to get a puppy gave her the strength to press ahead in her ongoing journey of rebuilding her self-esteem.
In terms of appearance, Ms Chuah traded wearing feminine, floral dresses that she used to love for more "neutral clothing" such as T-shirts and shorts, or longer dresses that were not in a "revealing style".
"I had many specific worries, like wondering if people would notice that my breasts weren’t symmetrical or thinking that I didn’t look 'right' as a stewardess anymore.
"I even questioned whether people would think my husband could have chosen someone more attractive or feminine than me."
However, bolstered by supportive colleagues who complimented her new look, with some even saying it made them want to try a short haircut, Ms Chuah has slowly found the new "her".
"My husband was also a constant source of reassurance, reminding me every day that I wasn’t any less beautiful than before."
The couple shares their cosy home with a two-year-old corgi, TanTart, whose name is a play on the Mandarin words for egg tart and her husband's surname Tan.
The dog was a comforting presence during our interview, regularly interrupting our chat for cuddles.
"Since we can't have our own children anymore, TanTart truly feels like a daughter to us," Ms Chuah said with a smile.
“Whether it's getting a puppy or reconnecting with things that bring you joy, every small decision adds up to a meaningful life.”
Having grappled with feelings of insecurity, she now has nothing to hide about her diagnosis and wants to actively address the feelings of isolation that often accompany patients dealing with cancer.
“When I was first diagnosed, I felt lost, uncertain about what lay ahead. Reading stories of others who had gone through similar experiences gave me hope. Now that I’ve stepped out on the other side, I want to offer that same hope to others.
“No matter how difficult the journey is, it’s important to keep living the life you want. My diagnosis made me realise I couldn’t keep waiting for the right moment."
