Lounge
Breast cancer awareness: What you should know before a mastectomy
Summary
The idea of getting a mastectomy can seem daunting. Breast cancer survivors and doctors talk about what to expect before and after the procedureEarly this year, news of actor Olivia Munn being diagnosed with breast cancer and her subsequent decision to undergo double mastectomy, became a talking point. Like actors before her including Angelina Jolie and the recently deceased Shannon Osbourne, Munn, too, has become an advocate for breast cancer awareness and mastectomy as a preventative measure.
Breast cancer is considered the most common cancer among women, affecting about 1 in 8 in their lifetime. As per a WHO study released in March this year, around 2.3 million women were diagnosed with breast cancer in 2022, and the number is estimated to rise to 3 million by 2040.
Also read: Turning 40? A guide on all you need to know about getting a mammogram
A mastectomy— either partial or complete, is one of the treatments for breast cancer. Be that as it may, the idea of losing one’s breast, even if partially, can be overwhelming and daunting. Cancer survivors and doctors talk to Lounge about what to expect before and after the procedure.
Mumbai-based Gita A. Parekh underwent a double mastectomy in 2014. Of the after-effects of the surgery she had to endure, the psychotherapist and tarot card reader says, “The doctor only prepares you for the surgery. Post-surgery, I experienced swelling in my lymph nodes, especially in my armpits." In addition to the physiological impact of a mastectomy, Parikh also talks of the mental anguish it can leave you with. “A beautiful part of your womanhood is gone. And that makes you feel like you’re less than," she says, drawing from her own experience. Not just that. “No two days are the same post the surgery. While on some days you might feel absolutely fine, there are days, you’d feel low and emotionally drained out."
“The feeling of void you experience isn’t something one can be prepared for. An acceptance that comes from within is the only thing that will help you," says 68-year-old Mumbai-based Christine Gonsalves, who underwent mastectomy about 21 years ago.
Talking from her own experience, Gonsalves says, whether you’re recommended to undergo a single or a double mastectomy, the choice can feel like a dark cloud hanging over your head. But you need to make the decision, in consultation with your doctor, after factoring in long-term effects. Parikh, for instance, decided to undergo a double mastectomy even though cancer was detected only in one breast. “Firstly, I was large-breasted and didn’t want to be lopsided. More importantly, my doctor intimated that there was chance of cancer occurring in the second breast. So, after reading up a lot and considering I was going under the knife anyway, I opted for a double mastectomy," she shares.
For Gonsalves, it was her husband who took the decision. “When I was diagnosed with cancer, I was emotionally not in the right state to decide if I should go for a mastectomy or not. It was my husband who made the call," Gonsalves recalls. What left her shocked, however, was meeting several women who had undergone mastectomies and discovering how unaware they were about the importance of exercising one’s arms after the surgery.
“It would a great idea to meet a physiotherapist before your surgery and discuss what exercises one should do with the arms after surgery. My doctor was extremely helpful. She started me with gentle finger crawling exercises, and eventually, guided me to exercises that involved raising my arms. Thanks to those routines, I can swim easily today," says Gonsalves who doubly emphasises on the importance of exercise as “lymph edema – the swelling of lymph nodes – can take place even years after surgery, if one isn’t regular with exercise."
Post-surgery exercises are important
A mastectomy could make you feel depressed but that shouldn’t stop you from ignoring post-surgery care, observes Dr Aditi Agrawal, breast oncologist surgeon at Wockhardt Hospitals, Mumbai. “If proper exercises aren’t done, it could lead to complications like drooping shoulders and backache. This is because the chest is now lopsided, not symmetrical. This is a cause for concern, more so, if one doesn’t opt for prosthesis," she adds. “In some cases, where the breast can be conserved, the decision to go for a lumpectomy (surgery to remove cancer cells and a small portion of the breast tissue) or a mastectomy, rests on the patient," says Dr Jyoti Nagda, a Mumbai-based senior health counsellor, who consults with breast cancer patients. Nagda too, emphasises on the importance of physiotherapy and arm exercises post surgery. “Other than that, the surgery in itself isn’t complicated and the patient can get on with their normal routine within 48 hours," she assures.
Sometimes, even after years, women who have undergone a mastectomy, could feel the presence of a phantom limb or even feel a prickling sensation, says
Dr Suparna Ajit Rao, PD Oncologist at Hinduja Hospital in Mumbai. This probably explains why breast prostheses is a common post-mastectomy treatment. An artificial form designed to replicate a person’s original breasts, breast prostheses can be made using foam, polypropylene beads and soft silicone gel, which is the most popular material. “Once my wound was healed, I went for silicone protheses, which are very comfortable. No one would doubt that they aren't real. I wear the prostheses even when I go swimming, it doesn’t look unnatural at all," Gonsalves says.
Sumitra Nair is a journalist based in Kochi, Kerala.
