Life Without a Breast: Exploring the Experiences of Young Nigerian Women After Mastectomy for Breast Cancer

Abstract

PURPOSE The majority of women managed for breast cancer in Nigeria are relatively young, many in their forties. Mastectomy, the most common surgical treatment, raises psychosocial concerns. Understanding these concerns may help address the fears of women who refuse treatment and aid in the care of those who have had mastectomy. METHODS Using qualitative methods, we purposively sampled women 45 years of age and younger who underwent mastectomy for breast cancer at a Nigerian teaching hospital. One-on-one in-depth interviews were conducted using an unstructured interview guide. Data were transcribed verbatim and analyzed to identify themes and subthemes. RESULTS The study identified six major themes on the impact of mastectomy on psychosocial lives of women, namely decision for mastectomy, postmastectomy transition, body image changes, relationship with husband and sexual life, coping with life postmastectomy, and social support. CONCLUSION Our findings highlight the importance of addressing individual patient’s psychosocial needs and preferences when discussing breast cancer treatment with young women. The experiences of women described in this study reveal several useful themes for planning treatment protocols and postmastectomy care.

Qualitative exploration of sexual life among breast cancer survivors at reproductive age

“…Furthermore, difficulties in sexual life consisting of posttreatment disturbances in body image and feelings of unattractiveness seem to be highly prevalent among BC survivors [34]. Consistent with our results, a qualitative study on Nigerian women after mastectomy demonstrated that mastectomy had a remarkable influence on the women's perceptions of femininity and reduced their sexual function [35]. A phenomenological study in Jordan showed that many women with BC were dissatisfied with their appearance and particularly were sensitive regarding their sexual unattractiveness due to cancer treatments.…”

Contemporary management of breast cancer in Nigeria: Insights from an institutional database

“…Phenotypically, evidence suggests a relatively young median age of diagnosis and higher proportion of triple‐negative breast cancer (TNBC) 7 . These biological variables are confounded by delays in presentation that result in a significant burden of advanced stage disease 8‐10 . Understanding these factors and how they relate to poor outcomes are central to the design and implementation of effective interventional programs.…”

Impact of Mastectomy on Body Image and Sexuality from a LGBTQ Perspective: A Narrative Review

“…Combined brief psychosexual intervention and counseling after a mastectomy is necessary to help post-mastectomy females in body image self-acceptance and perceived partner acceptance positively [ 49 ]. Excellent social support [ 50 ] and strong married relationships can improve the quality of sexual life after mastectomy [ 9 ].…”

“…This finding implies that unique post-operative care for each gender identity is demanded. As men are a minor group of breast cancer patients and gender-classified data collections for LGBTQ are scarce, studies regarding their cases were not able to establish a direct relationship between mastectomy and sexuality [ 9 ]. Therefore, this short narrative is a call for diverse gender classification in data collection systems and more research into sexuality among LGBTQ and men breast cancer patients after mastectomy.…”

“…Although the surgical procedure could lead to a decrease in the sexual performance among patients [ 6 ], only a handful of studies focused on the psychological and sexual behavioral aspects after the operation [ 7 ]. The vast majority of research on post-mastectomy sexuality has focused mainly on female subjects but barely on LGBTQ and male patients [ 8 , 9 ]. Meanwhile, sexual and gender minority BC patients undergoing mastectomy expect a complex treatment plan in terms of physical and emotional outcomes.…”