Dr Jozelle Miller
September 1, 2015
‘I am not my breast’…. offering support through breast cancer

Breast cancer is the most common malignant tumour in women, and amidst the great progress in its early detection and treatment, as well as improvement in the diagnosis of the disease, mastectomy (breast removal) continues to be practised. In understanding and weighing the odds to save their lives, as opposed to keeping a breast; there is no doubt that the choice of life wins every time. But the decision to remove the breast doesn’t come without its psychological and physical challenges.{{more}} Research has shown that having a mastectomy (breast removal), causes more trauma than the cancer illness itself; as such, it is important that loved ones understand the trauma involved and appreciate the delicate nature of such a decision, being sure to exercise wisdom and compassion in responding to a woman who had to take such a major operation.

A Woman’s Body Image:

The breast is part of the female “body image,” being appreciated from the erotic point of view, which is often the expression of her own worth and power. Women are known to express a love for their breast. It adds to the level of self-confidence as a sexual partner and it enhances the overall body image of a woman.

Mastectomy (breast removal) involves the loss of this worthy image; it is considered an attack to the body image, causing great worry about aesthetic features from that moment, which provokes the thought that she does not feel beautiful. She may testify:

“When I see myself, I do not feel I have any charm, and this is a huge problem for me. I try to accept it, but I cannot.”

Then it is not strange that she avoids looking in the mirror, which is a reference to the personal charm that no longer exists:

“My appearance was like a freak, I felt sorry for myself.”

This lady would avoid all those situations where she has to expose her body to the gaze of others (beaches, pools, gyms, etc), in a way to hide herself. It may also extend to her home:

“I used to walk naked around the house, but since my operation I won’t do it anymore.”

The loss of courage related to a single part of the “body image” is transmitted to the complete self-image and also to the whole personality, showing then a characteristic chain of thought: “My breast is not worthy” – “my body is not worthy” – “I’m not worthy.” This leads to a fall in the self-esteem that drives the woman not to like herself or even to reject herself, which also leads to an attitude of introversion, inward-looking, shyness, insecurity, confinement, and/or social inhibition, which did not exist before the problem or at least were not so emphasized.

One woman’s struggle with inferiority:

“I hate the way I am, because I do not feel like the other women – I’m not complete. I feel I’m not worthy and I do not know how to explain it. When I’m with my friends, I become a shy person, since I feel I’m inferior. I do not understand how this can make such an influence on me, since it not only stop me in intimacy with my spouse/mate, but also with the visitors who come home and I’m speechless when I am with them, as though I had no words and could not express myself. This had not happened to me before. And I am tired of the question which comes over very insensitive… ‘YOU ONLY HAVE ONE BREAST?’”

How to cope after a mastectomy:

1. Keep a positive attitude. To help deal with the loss of your breast or breasts, it’s important to focus on the positive.

2. Talk with your partner. Many women may worry about their sexual relationships after a mastectomy – and may wonder if others will still find them attractive. Women also may miss the sensitivity and pleasure derived from touching their nipples and breasts. Talk with your partner and share your concerns and fears. You will probably discover that there are many characteristics beyond your breasts that make you attractive and womanly to your partner.

3. Consider breast reconstruction or breast prosthesis, which some woman do to help feel more like themselves and improve self-esteem, or they may opt for plastic surgery to reconstruct their breasts.

4. Do things that make you feel healthy and good about yourself. Figure out what helps you feel good about you, and stick to that regimen.

Bottom line: Although a mastectomy can change your feelings about yourself and your body, it’s important to remember that you’re worthy of love and attention – both from yourself and others. By staying positive and surrounding yourself with a good support system, you can undergo a mastectomy with your self-esteem intact.

Keep saying… I am not my BREAST!!!!

Dr Miller is Health Psychologist at the Milton Cato Memorial Hospital.