It's one of the most traumatic things a woman can go through.
But a breast cancer survivor from Northern Ireland has found a unique way to celebrate the beauty of her body following a double mastectomy.
Instead of marking her 40th birthday with candles and cake, Nic Russell had a series of stunning nude photographs taken to celebrate her post-operative body.
Now living in Auckland, the Co Down native is behind a major campaign in New Zealand to empower women to embrace their new form after going through the ordeal of having their breasts removed.
The Cranfield woman, who has vowed to wear her "scars like stars", recently organised a successful photographic exhibition called Hope Emerges in her adopted home of Devonport, a harbourside suburb of Aukland.
The exhibition featured 60-plus tasteful images of herself and three other women who have all undergone recontructive surgery after double mastectomies.
She intends to launch Hope Emerges as a national campaign in New Zealand and hopes that it will ultimately go global.
The mother-of-two chose to have a double mastectomy followed by recontructive surgery at the most challenging time of her life.
Just four months before she was diagnosed with an aggressive form of breast cancer in July 2005, her daughter Kenzie (2) was diagnosed with the rare bone cancer Ewing's sarcoma.
She sadly passed away in December of that year.
"I was diagnosed with breast cancer when I was 31 and was told by medical staff that they would be hard- pushed to keep me alive by 40. So when I hit 40 recently I just thought: 'Well, I am alive and I want to celebrate it'.
"But, initially, it was a small private thing," said Ms Russell.
A lover of the sea, Ms Russell had her photoshoot taken at North Head, Devonport, a spot where she sought solace during her daughter's illness.
The photographs were so powerful that others wanted to do it as well and the idea for the exhibition was born.
Ms Russell said: "I wanted to start a whole new conversation about breast surgery and mastectomy
"When women are first told that they need to have a double one performed and need reconstruction, the images that they see on Google or are shown by doctors can be very stark and graphic, and quite harrowing.
"Any other projects that have photographed women post-reconstructive surgery have spoken more about sadness and loss, and I wanted to show it how it really was for me and for other women."
A communications consultant, Ms Russell has campaigned on breast cancer issues before and led a successful three-year fight to get the New Zealand health authorities to fund the cancer drug Herceptin for women with breast cancer.
She hopes to widen the campaign out to include women from the Maori, Asian and Pacific Island communities in New Zealand, and Northern Ireland as well.
For more information on the campaign by Nic, visit www.hopeemerges.co.nz.
In May last year Hollywood star Angelina Jolie stunned the world by revealing she had had a preventative double mastectomy.
She said she carried a "faulty" gene, BRCA1, which sharply increased her risk of developing cancer – an 87% risk of breast cancer and a 50% risk of ovarian cancer.
After she went public there was an upsurge in the number of women getting checked for cancer in the UK and US.