Managing the Emotional Aspects of Breast Reconstruction

By Constance M. Chen, MD, MPH

More than 268,000 new cases of breast cancer were diagnosed in 2018, according to estimates by the American Cancer Society. Many of these breast cancer patients need to decide whether or not to undergo undergo mastectomy and breast reconstruction. A breast cancer diagnosis is difficult, and coping with decisions about surgical treatment and its aftermath adds an extra layer of complexity to the diagnosis.

Fortunately, many tactics and resources can help manage the emotional aspects of mastectomy and breast reconstruction. “It’s physically and emotionally taxing to adapt to the changes in your body and your life after breast cancer. It’s abundantly clear why breast cancer patients would need effective tools to manage the emotional aspects of this tumultuous journey.”

Reconstruction can offer sense of control

Often, one of the ironies of dealing with a breast cancer diagnosis is the need to decide whether to undergo mastectomy, and if so, whether, when and how to have breast reconstruction. There are two main types of breast reconstruction – either using implants or a patient’s own tissue to create new breasts – but sometimes, part of the emotional burden of breast cancer is the choice itself.

According to 2014 research in the Journal of the American College of Surgeons, fewer than 40% of women who undergo mastectomy choose to undergo immediate breast reconstruction. For many women, they are not offered breast reconstruction because it is not available where they live. For others, the advanced state of their disease may force them to conserve their energy on physical survival alone. While breast reconstruction after mastectomy can lengthen a woman’s initial hospital stay and recovery period, however, doing so can provide important emotional advantages.

For many women, it’s very helpful to wake up from a mastectomy and look down to see that she still has breasts. And even if a woman chooses to or is advised to wait for reconstruction surgery at a later date, being able to look forward to regaining a more natural and familiar body shape offers a sense of control, which can help calm her during an emotional time. Women who opt to forego reconstruction can also achieve a sense of normalcy by using a mastectomy bra with slots for breast forms. Either way, looking and feeling more like their pre-mastectomy selves can help a great deal emotionally.

Tips to find support

It’s OK – in fact, it’s expected – that you may need emotional and social support during the period surrounding breast cancer treatment, especially for women who’ve undergone mastectomy and breast reconstruction. It’s normal to mourn the loss of your breast(s) due to mastectomy and to be worried about the breast reconstruction process. Here are some ways to seek support and insight:

• Communicate:

  Open communication with your partner and your surgeon helps manage expectations and concerns.

• Find a therapist:

  One-on-one therapy is often incredibly helpful for dealing with the tough emotions following a mastectomy. Therapists – especially those who often deal with cancer patients – can help women cope with feelings of a changing body, femininity, and any accompanying anxiety or depression.”

• Check out support groups:

  “Breast cancer support groups at your local hospital, or even online, can connect you with others in your shoes,” she says. “For example, Young Survival Coalition (www.youngsurvival.org/) is targeted toward women under the age of 40 years who are diagnosed with breast cancer, and Facing Our Risk of Cancer Empowered (www.facingourrisk.org) is targeted toward people affected by hereditary breast and ovarian cancer. We even have our own group of patients, the Bosom Buddies (http://constancechenmd.com/bosom-buddies) who are committed to helping other patients in their breast reconstruction journey.”

• Tap the American Cancer Society: If you’re feeling at loose ends about who can help you manage your emotions, call the ACS at 1-800-227-2345 to be connected with a group or resource that can work for you. https://www.breastcancer.org/

Breast cancer can feel very lonely, but you don’t have to deal with overwhelming feelings about mastectomy and reconstruction on your own. It’s important to know that you have support and that your family, friends, and health care providers are there to help.

Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. www.constancechenmd.com