Mastectomy in a Large Public Hospital

Abstract

Thirty women undergoing mastectomy for carcinoma of the breast in a large teaching hospital were interviewed. All indicated a very real need to discuss their experiences, and felt that the interview had been beneficial to them. Most had found the “lump” themselves – but often described it as a “hardness”, a “ridge”, or a “thickening”. More than half felt that the counselling afforded to them had been inadequate – especially in the realm of sexual adjustment – but, if their marriages had been stable before operation, subsequent deterioration was unlikely. The threat of malignancy, rather than that of breast loss, was uppermost in the minds of most patients. It should not be assumed that postmastectomy problems do not exist because patients do not mention them, especially in large busy follow‐up clinics, where privacy may be inadequate. If doctors are unable or unwilling to afford this service to their mastectomy patients, It may be necessary to delegate it to other health professionals and mastectomy volunteers.

Sexuality and Cancer in Women

“…Two years after treatment a substantial proportion of the benign patients and the cancer patients experienced changes in their sexual relationship (32% of the cancer patients vs. 27% with benign disease). Conversely, Battersby et al (1978) observed little change in sexual function in their study, probably because they assessed a sample of elderly, stable, married women.…”

“…-age (Battersby et al, 1978;Cotton et al, 1991;Hughon et al, 1988;Jamison et al, 1978;Mooradian & Greiff, 1990); -t h e different aspects of body image (Aaronson et al, 1988;Bartelink et al, 1985;Beckmann et al, 1983;DeHaes et al, 1986;Ganz et al, 1987;Hopwood &Maguire, 1988;Kemenyetal., 1988;Lasryetal., 1987;Sänger & Reznikoff, 1981;Schain et al,1983;Steinberget al, 1985); -premorbid sexual functioning, sexual history (Andersen, 1990;Schover, 1991;Schover, Schain, & Montague, 1989;Walbroehl, 1985); -quality of the (marital) relationship (Andersen, 1990;Baider et al, 1986;Schover, 1991); -decision strategies where treatment options are available (Aaronson et al, 1988;Ashcroft et al, 1985;Baider et al, 1986;Beckmann et al, 1983;Cotton et al, 1991;Dean 1987;Fallowfield et al, 1986Fallowfield et al, , 1990Kiebert et al, 1991;Sänger & Reznikoff, 1981;Steinberg et al, 1985;Wilson 1988;Wolberg et al, 1987Wolberg et al, , 1989; -personality differences and the sense of control (Eicher et al, 1977;Fallowfield et al, 1990;Taylor et al, 1984); -t h e role of depression and sexual functioni...…”

Sexual functioning morbidity among cancer survivors. Current status and future research directions

“…With the exception of one survey, 14 estimates of general sexual disruption, reduced frequency of intercourse, or specific difficulties with orgasm range from 21% to 39% of the patients sampled retrospectively. 8,[15][16][17][18] These studies were conducted by individuals previously unfamiliar to the women, and despite their differing assessment strategies (i.e., interviews or mailed questionnaires) and treatment institutions, findings were convergent. The single investigation reporting a significantly lower level of sexual distress for patients was a questionnaire survey of 278 Mayo Clinic patients.…”

Sexual functioning among breast cancer, gynecologic cancer, and healthy women.

“…Sexual functioning, however, has rarely been the focus of any investigation; instead, sexual data have been obtained with mood, social activity, or family relationship data. From such studies, estimates of general sexual disruption, reduced frequency of intercourse, or specific difficulties with orgasm range from 21% to 39% for the patients sampled retrospectively (Battersby, Armstrong, & Abrahams, 1978; Becker, 1979; Frank, Dornbush, Webster, & Kolodny, 1978; Jamison, Wellisch, & Pasnau, 1978; Silberfarb, Maurer, & Crouthamel, 1980) and are 30% for the patients followed prospectively (Maguire et al, 1978; Morris, Greer, & White, 1977).…”