Many women with breast cancer learn about their diagnosis from a mammography. The eligible treatment for breast cancer is the surgery of the tumor (lumpectomy) or of the breast (mastectomy), that makes 80-90% of women to overcome the disease. But it also entails a huge psychological impact. This post explains how to deal with a mastectomy and how familiy and friends can help a woman that has gone on this procedure.
Post updated on 15. of December 2025.
Diagnosis and treatment of breast cancer
The mammography for an early diagnosis
1 out of 9 women will be diagnosed with breast cancer at some point in her life. Is many cases cancer is detected thanks to early diagnosis programs (mammographies). In Catalonia women between 50 and 69 years old are invited to involve to it every 2 years. When a women is found to have a tumor in her breast in an early stage, it can be detected with a mammography. This makes treatment simpler and more effective.
42 million mammograms were reported in the United States in 2024, slashing the risk of dying from breast cancer almost in half.
Surgery in breast cancer: lumpectomy and mastectomy
In most cases it is a carcinoma which either has not spread or it has spread just a little bit. Therefore, surgery is the eligible treatment. If the tumor is really small, even chemotherapy might be unnecessary, and lumpectomy should be enough. Lumpectomy consists of a surgical treatment for removing the tumor and those cells around it, with breast preservation.
With tumors a little bigger mastectomy is elected. A mastectomy is the complete or partial removal of the breast: it can be removed a quarter, half or the entire breast. Removal of both breasts (because both are affected or there is a risk that this happens) is called bilateral or double mastectomy. Depending on the spreading grade of the tumor, many lymph nodes and part of the muscle tissue can be removed too.
The sentinel node
If you search information about dealing with a mastectomy or about its procedure, you may have found something about the sentinel node. Studying the sentinel node helps to check whether breast cancer has begun to spread. Since this node can’t be seen through a mammogram, it is analized in the middle of the surgery.
Nodes are a part of the lymphatic system, a channel network that belongs to the immune system to eliminate pollutants. The body parts where more lymph nodes can be found are the neck, the armpits and the groin. These nodes are arranged like a chain, connected among each other like subway stations. Fluids collected by lymphatic system move from node to node.
In the middle of the mastectomy, surgeon injects a fluid to the tumor, that spreads along all of it. If the injected fluid is found to reach a lymph node, that means cancer has cleared a path to it, it has begun to spread along the lymph chain. The first node where this fluid arrives is the sentinel node. Pathologist can analyse it in the middle of the surgery to see whether other nodes must be removed.
Lymphedema
Lymphedema is the inflammation of the arm due to a lymphatic fluid accumulation. Nodes removal interrupts the lymphatic chain: fluid cannot run and it accumulates in the arm. In that case, not to wear tight clothes, taking care of skin and maintaining a balanced diet, low of salt is recommended.
Besides this, removal of muscle tissue can limit the arm movement (for example, arm may not be able to rise above shoulder).
In any cases, medical counseling is key to prevent complications and recover functionality. Physical activity is a good resource, but doctor must give advice on how to do it.
Dealing with a mastectomy
Your breast is a fundamental part of your body: it explains your femininity, your identity and your self-image. Therefore, losing a breast or a part of it leaves both visible and psychological scars.
This experience is often perceived as a mutilation. At the same time it’s a very personal experience: many women have it easier to accept than others. Whatever, you need time to deal with it. Each woman does it at her own pace.
“After mastectomy I feel like a part of me has gone. It’s like seeing another person in the mirror”.
You may think you have lost what made you attractive and that your partner is going to reject you. Most of the times, the partner accepts the change and is willing to help. However, he can be afraid of saying of doing something inappropiate, and that’s why he is so cautious. As you advance in your acceptance of the changes, your partner will also accept them.
Remember that recovering wellbeing is, firstly, for yourself. The aim is you to be good to yourself before doing so to others.
The most common emotional reactions are anger, sadness, fear and disgust. They are normal and you can give yourself permission to experience them. You can get angry, cry or shout when your body asks you to, being alone for a while when you need it, etc. It can be helpful to talk about that with trustworthy people, with other women which went to a mastectomy as well, or with health professionals. Most hospitals have a Breast Care Unit, with nurses that have vast experience to solve any situation that can arise.
In order to get used to this new image, the successive approximations method exists: it consists of exposing yourself gradually to your own body and scar, and showing it to others:
- The first day, look at yourself, dressed, in front of the mirror and stay there for some minutes. Do it alone (with nobody close to you).
- The second day, also alone, spend a few minutes looking at your self in front of the mirror in underwear.
- The third day you can do the same but naked. Alone. If you feel fear, sadness, disgust, etc, try no to fight it. This reaction will come, pass and fade away.
- The fourth day, repeat this exposure naked, and touching your scar, changing your posture: one side, the other side, nearer and further the mirror, etc.
- Later, when you feel ready, repeat these steps accompained by your partner or anyone you trust.
Breast reconstruction
After some time, a prosthetic breast reconstruction can be done, to recover the original shape of breast -some hospitals allow to conduct both mastectomy and reconstruction in just one intervention-. With micropigmentation (a procedure similar to a tattoo) nipple and areola can be recovered, with an astonishingly realistic look.
To go through a breast reconstruction or not is a personal decision. Both choices are equally right and deserve the same respect. In that sense, more women everyday decide not to go on it and, instead, to preserve their look after mastectomy. And they do so, among other reasons, because they don’t want the reason to be the aesthetic pressure which tells them they need “a perfect body”. Radio show Les dones i els dies, in Catalunya Ràdio, dedicated an episode to this issue [IN CATALAN]:
In any case, this breast reconstruction is not a cosmetic surgery in terms of “improvement”. It’s a way to recover the body as it used to be before mastectomy.
If there must be a time interval between mastectomy and reconstruction, there are temporary solutions that help to cover up the difference in volume between both breast: padding for clothes, etc.
How can we help a woman to deal with a mastectomy
Not only the patient hesitates about how to deal with a mastectomy. Also their family and friends wonder how can they help her.
It is important to respect her adjustment pace to this new situation, and allow her to experience -and to express- those emotions she might be feeling at every moment. Phrases like “You should be happy because surgery was successful” or “Don’t worry, you can go on a reconstruction and no problem” usually don’t work, no matter how good is their intention. She is worried, she has reasons to and she has the right to. Playing down her suffering won’t help her.
Some things she may need (and that can vary often) are:
- To be accompanied by somebody when she goes shopping clothes that will help her to cover up the scar.
- A while of distraction, talking about anything.
- Somebody to express her fears or hesitations to.
- To sit down close to her when she explains to her children why her body has changed.
- Not to feel others taking pity on her. She wants to be treated as usual, with sincerity (but respectfully) and without overprotection.
- If she accepts it, humor can be used to talk with her about what she is going on. Humor can help to make this easier and to deal with difficult conversation.
- If you don’t know what she needs, the best way to find it out is asking her.
It is also key to respect her decisions, whatever they are. She may need some time before posing naked in front of her partner; she can reject
Leave your question or comment and I will answer to you. And if you think this post about how to deal with a mastectomy can help someone you know, share it!!
Leave a Reply