In American society, breasts are a focal part of female sexual attractiveness, and women often invest much of their feminine self-image in their breasts. For many years, a diag­nosis of breast cancer usually meant that a woman lost that breast; mastectomy was the preferred treatment. Simple mastectomies meant that the breast tissue alone was re­moved, whereas radical mastectomies involved the removal of the breast along with

simple mastectomy

The surgical removal of the breast tissue.

other tissues and lymph nodes. As we discussed in Chapter 4, the numbers of mastec­tomies have decreased today, and many women are opting for lumpectomies. These are often coupled with chemotherapy, radiation therapy, or both. Still, some women must undergo radical mastectomies and must contend not only with having cancer, but also with an altered image of their sexual identity.

There might be very little time to prepare oneself psychologically for the loss of a breast. One woman who had a mastectomy years ago reported: “It all happened so fast. I was told on Friday, and on Monday it [the breast] was off’ (Sandowski, 1989, p. 166). A woman who loses a breast may worry that her partner will no longer find her attrac­tive or desirable. Some go so far as to wear their bras when making love or to avoid look­ing in mirrors when nude.

In order to wear the clothes they are used to wearing, many woman missing a breast (or both breasts) will wear a prosthesis. Other women choose to undergo breast reconstruction, in which tissue and fat from other parts of the body are molded into the shape of a breast and im­planted under a fold of skin, or fluid-filled implants are added. Years ago, reconstructed breasts were not very satisfactory, but recent advances in reconstructive techniques can create a much more natural-looking breast. Surgery can also create a realistic looking nipple, although some women are satisfied with just the form of a breast (Sandowski, 1989).

There is no reason that a mastectomy should interfere with normal sexual functioning. The most important factor in resuming a normal sex – Image not available due to copyright restrictlons

ual life is the encouragement and acceptance from the woman’s sexual partner, assuring her that she is still sexually attractive and desirable.