October is Breast Cancer Awareness Month, a time to honour survivors and recognise that recovery often continues long after treatment ends.
For women who undergo mastectomy, the journey involves more than physical healing. It can also mean confronting grief, rebuilding confidence and learning to live in a changed body.
The first time a woman looks in the mirror after a mastectomy, she may see more than a surgical scar. The reflection may bring back memories of a frightening diagnosis or remind her of a part of herself she is not ready to mourn.
For some, it brings relief and hope after cancerous tissue has been removed. For others, it triggers sadness, shock or a sense of loss. Some experience all these emotions at once.
A mastectomy, the surgical removal of part or all of a breast, can be life-saving. Yet the emotional experience of living in a changed body often receives less attention than diagnosis, treatment and survival.
A woman can be grateful to be alive and still grieve the breast she has lost. These feelings do not diminish her courage or gratitude. They are part of the complex experience of surviving cancer.
For nurse Sophie Makuva, a breast cancer survivor and leading nurse at Lion’s Eye Hospital, losing one breast brought fear, emotional challenges and additional expenses.
“I was confused at first. I was in denial and lived with the fear of being judged. But after some sessions with my therapist I embraced myself,” she says.
Makuva began looking for a prosthesis to help her feel comfortable with her changed body. Hair loss during treatment also affected her confidence, prompting her to buy wigs.
“I regained my confidence back,” she says.
Her experience highlights how recovery extends beyond surgery. Women may need time to become familiar with scars, changes to their chest, altered sensation and how their bodies look in clothing.
Breast reconstruction can restore breast shape, but it does not always recreate the original breast or resolve every emotional concern. Some women choose reconstruction, while others use external prostheses or decide not to reconstruct their breasts. Each choice is personal.
The type of mastectomy also varies depending on the nature and extent of the disease, a patient’s medical circumstances and, where appropriate, her preferences. A total mastectomy removes the breast, while a modified radical mastectomy also involves removing certain lymph nodes. Skin-sparing and nipple-sparing procedures may preserve some breast skin or the nipple in eligible patients, while a bilateral mastectomy involves removing both breasts.
Understanding the procedure can help women prepare for physical changes, but it does not necessarily prepare them for the emotional adjustment that follows.
Psychological recovery after mastectomy is rarely straightforward. A woman may initially concentrate on surgery, pain management, appointments and further treatment. The emotional effects may become more apparent when the immediate demands of treatment begin to ease.
Psychologist Maureen Ngari of Hearted Stories emphasises that experiences vary from one patient to another. Some women feel relief after surgery, while others experience distress or move between different emotions throughout recovery.
A woman may understand why surgery was necessary and still struggle with its consequences. Changes in body image can affect self-esteem, relationships and feelings of femininity, although every woman’s experience is different.