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What Affects Intimacy & Satisfaction after Prophylactic Mastectomy & Breast Reconstruction



Hello boys and girls. Today we’re going to discuss mastectomies and breast reconstruction.

Definition: A mastectomy is a surgery that removes the whole or as much of the breast tissue as possible.

There are different types of mastectomies, but basically, the purpose of a mastectomy is to remove the cancerous breast from the body in order to prevent the spread of cancer to other parts of the body. It is (in my understanding) a life-saving measure.
With growing knowledge of genetic mutations and their association with an increased risk of breast cancer, more women are choosing to undergo risk-reducing mastectomy and breast reconstruction. This growing trend led researchers to examine what factors influence a patient’s intimate life and overall satisfaction with their breast reconstruction outcomes.

Choosing to undergo a prophylactic mastectomy is a major life-changing decision and can be a good option for patients who are at high risk of developing breast cancer. In certain situations, prophylactic mastectomy can reduce the risk of breast cancer by 90%-95%.

Breast reconstruction is also an option following preventative mastectomy and can be performed using implants or the patient’s own tissue. Regardless of the reconstructive procedure performed, changes in breast sensation and appearance may impact a patient’s intimate life and overall satisfaction with their final results.

It is crucial for surgeons and patients to have honest discussions regarding patient wishes and realistic expectations. This is called Shared Decision Making and I believe it is the most important aspect of patient-centered healthcare! Patients and their doctors should work together to make the decisions for individualized care. Time should be taken to discuss ALL options and the pros and cons of each before creating a surgery plan.
Although reconstructive techniques have come a long way, it is important for patients to understand final results will not always look or feel like what Mother Nature provided. For example, during the prophylactic mastectomy, nerves supplying feeling to the breast will be cut. This results in a lack of sensation or numbness in the breast. For patients choosing to have tissue-based reconstruction (like the DIEP flap), sensory nerve reconstruction can be performed and can help restore sensation to the breast. Unfortunately, this is not an option for implant reconstruction patients at this time.

Regardless of the procedure being performed, patients should know more than one procedure is typically required for optimal cosmetic results. Referred to as the “Revision Stage” or “Stage 2,” this procedure is designed to fine-tune the reconstructed breast(s) in order to improve the overall cosmetic appearance.

Women undergoing prophylactic mastectomy and breast reconstruction have many options available to them today. By understanding patient needs and discussing realistic expectations, overall satisfaction with reconstruction results and intimacy can be achieved.

Pamela Acker
Email: brececan2018@gmail.com

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