Psychological Effects of Mastectomy
Breast cancer is the most common malignant tumour in women. Nowadays there has been a great progress in its early detection and treatment, improving the outcome of the disease. When a woman is diagnosed with breast cancer, the initial priority is to treat the disease. This treatment includes lumpectomy, mastectomy, chemotherapy, hormonal therapy, radiation therapy or a combination of these with or without reconstruction. However, during the search for an appropriate treatment option, the woman must also be informed about many other issues. One issue that is frequently overlooked is the sexuality needs of a woman before and after treatment. It is said that mastectomy causes more trauma than the cancer illness itself, hence there is a need to deal with this issue in order to provide psychotherapeutic treatment for these women.
Women should understand early on that a mastectomy will affect them mentally almost as much as it will physically and that they should begin exploring therapies to help them cope with the emotional effects of a mastectomy even before their breast cancer surgery.
Breast, as part of the female body is an integral part of her self-worth. Mastectomy (breast removal) results in the loss of self-worth which is not observed in the surgical removal of any other tumour in females. She does not feel beautiful and she feels that her personal charm no longer exists. This leads to a fall in the self-esteem leading her to an attitude of introversion, withdrawal, shyness, insecurity, confinement, and/or social inhibition. Emotional distress, a sense of disconnection from one’s body and a diminished sense of femininity are observed amongst many breast-cancer patients who have undergone mastectomy.
After mastectomy one may choose to wear external breast prosthesis or nothing at all. Some women have breast reconstruction, using either breast implants or their own tissue. Breast reconstruction not only improves physical appearance it also has psychological benefits. It promotes a sense of wellness for the woman.
The choices for breast reconstruction are different for all patients. Breast reconstruction surgery for breast cancer is performed to replace skin, breast tissue and the nipple removed during a mastectomy. The amount of missing tissue varies with each mastectomy depending on the width, size and location of the tumour and its proximity to the armpit from which the lymph nodes are removed.
For the mastectomised woman, the acceptance by her partner is essential as they fear being rejected. Men must accept the situation and be empathetic towards them as if nothing has changed. There could be swelling of the arm caused by the lymphedema (swelling of the arm due to fluid build-up after lymph node removal) which provokes brachial asymmetry, chemotherapy causing loss of hair on head, loss of eyebrows and eyelashes making the problem more difficult as the face loses its definition. There could be an increase in weight and swelling as a result of the inactivity due to the fatigue and fluid retention as an after-effect of medicines. Women may have a temporary loss of sexual desire. Although she may take some time to get used to her body, a woman battling breast cancer can learn to love her post-mastectomy body and feel just as womanly and acceptable as she did before breast cancer treatment.
How to Cope After a Mastectomy
Keep a positive attitude – To help deal with the loss of your breast or breasts, it’s important to focus on the positive.
Talk with your partner – Many women worry about their sexual relationships after a mastectomy and wonder if others will still find them attractive. There are many characteristics beyond a woman’s breasts that makes her attractive and womanly to the partner. A mastectomy for breast cancer will not change a woman’s ability to enjoy sex physically, but it can make her feel a little self-conscious. Communication with partner and sharing the concerns and fears can be very helpful in maintaining a healthy, happy sex life after breast cancer.
Consider breast reconstruction or a breast prosthesis after mastectomy – A woman’s own breast tissue, implants, or breast expanders, or a combination of these, can be used to surgically enhance the appearance of breasts. Some women may choose to use a prosthetic breast, an artificial breast that can be worn under a bra to give the appearance of a natural breast.
Although a mastectomy can change a woman’s feelings about herself and her body, it’s important to remember that she’s worthy of love and attention – both from self and others. By staying positive and surrounding herself with a good support system, she can undergo a mastectomy with her self – esteem intact.