There’s no reason to feel less of a woman with a surgical procedure that preserves the breast. One in eight women suffers from breast cancer, and about 90 per cent of them have no family history of the disease.
To these women, being diagnosed with breast cancer evokes fear that spells doom. They imagine losing their breast, along with their self-worth.
But it’s a misperception that a patient has no choice other than to have her breast removed. With more women doing self-checks and going for screening these days, breast cancer is being detected in the pre or early stage. Thus, it’s possible for women to preserve their breast through a surgical procedure known as breast conservation.
Breast conservation vs. mastectomy
When the tumours are much smaller than the total breast volume, and where the cancerous cells are concentrated in one spot and have not spread to other areas, they can be removed and the rest of the breast, preserved. This is the general rule, but there are exceptions, of course.
It’s less severe than mastectomy, where the whole breast is removed, leaving a big, ugly scar on the chest. Mastectomy is usually done when the tumours are too large for breast conservation. A patient, who has undergone mastectomy, normally loses sensation – together with her ability to get sexually aroused through stimulation to the area.
Apart from the loss of sensation, a patient could end up lopsided if one side of her body were heavier than the other. As a result, her posture would be affected, causing a backache which could lead to poorer performance in bed.
There are also psychological issues to grapple with. One such patient revealed her 20 years of social isolation, as she felt she wouldn’t look good in evening gowns and couldn’t bring herself to go out to parties.
In contrast, the outcome of breast conservation is visually pleasing and the sensation is retained. So, sex life won’t be greatly affected. In addition, breast conservation allows a patient to fill out her clothes without having to fuss with prosthetic bras.
Can the breast be reconstructed after mastectomy?
Breast reconstruction is an acceptable method of treatment, and is widely performed by surgeons – if patients opt for it. In such cases, the breast is removed through an incision that’s the size of a nipple, leaving an envelope of skin behind. The breast is then reconstructed using tissue flaps, which are harvested from the abdomen or back, and relocated to the breast area.
While the end results are visually pleasing, patients may experience loss of sensation and internal discomfort. One patient, for example, complained she couldn’t sleep for more than a year because she felt a burning sensation under her abdominal wall and couldn’t lie on her back or sides comfortably. It affected sexual intimacy with her husband. The actual number of incidences may be higher, as many patients do not come forward with their problems. So, it’s important to weigh the risks before opting for the surgery.
Other factors affecting sex
A patient still needs to go for chemotherapy and radiotherapy to keep the disease at bay. These therapies will make her weak, nauseous and lose her appetite, and shed her hair. Hence, her partner should be understanding and accommodate her mood swings. On the other hand, chemotherapy can affect fertility, so if a couple has trouble conceiving, they should see a fertility specialist.
It’s important for the partner to get involved as his support is part of the recovery process. Apart from the odd husband who divorces his cancer-stricken wife, most spouses lend their support once they have been encouraged to do so. Therefore, breast cancer does not mean the end of one’s sex and social life.
Dr Woon is a private breast and laparoscopic surgeon at Gleneagles Medical Centre, Singapore. © LoveAirways Magazine Singapore