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Study Examines Impact of Breast Reconstruction on Women's Sexual Image


In a new study, women who had breast reconstruction after mastectomy (breast removal) were more likely to report that breast cancer had had a negative effect on their sex lives than women who had undergone mastectomy without reconstruction. The study also revealed that women who had breast-conserving surgery (lumpectomy) were the most satisfied with their body image after breast cancer.

Surgery is the most common form of treatment for breast cancer. Surgical options for breast cancer patients include lumpectomy (the removal of a breast lump and surrounding margin of normal breast tissue) and mastectomy (breast removal). Lumpectomy can help preserve the physical appearance of the breast; however, breast cancer may be more likely to recur after lumpectomy than mastectomy. In many instances, one form of surgery will be most favorable based on a patient’s medical situation (i.e., size and characteristics of the breast tumor, medical history).

According to the study, which is published in the September 6, 2000 issue of the Journal of the National Cancer Institute, women who had lumpectomies were the most satisfied with their body image, at least one year after breast cancer surgery. Women who had undergone mastectomy were less satisfied with their sex lives, regardless of whether or not they had breast reconstruction. After one year, the women associated their quality of life with other factors, such as age or subsequent cancer treatment.

Lead researcher Julia H. Rowland, PhD and her colleagues sent questionnaires to a total of 1,957 breast cancer survivors one to five years after their diagnosis. Questions concerned health-related quality of life issues, body image, physical and sexual functioning (i.e., arousal, desire, orgasm), etc.

Dr. Rowland and her colleagues were surprised to find that many women who had undergone breast reconstruction after mastectomy were not satisfied with their body image. However, the researchers suggested that some of these women may have wanted to have lumpectomies but were not good candidates for breast-conserving surgery. In the study, women who had mastectomies with breast reconstruction tended to be younger than those in the lumpectomy or mastectomy groups and were more likely to be white, have a sexual partner, and a college education.

In the study, women who had mastectomies (with or without reconstruction) were more likely to experience discomfort, arm swelling, and sensations of pins and needles in the breast area than the women who had lumpectomies.

Poor Candidates For Breast-Conserving Therapy (Lumpectomy) Include:

  • Patients with large breast tumors (typically Stage III and above)
  • Patients with a history of radiation therapy in the breast or chest area
  • Patients whose previous lumpectomy did not completely remove cancer
  • Patients who have two or more cancerous areas within the same breast
  • Patients who have connective tissue disease(s)
  • Patients who are pregnant at time of radiation therapy
  • Patients who are very worried about breast cancer recurrence and less concerned with body image

Women who are planning to undergo mastectomy are encouraged to discuss breast reconstruction options with their physicians. Some women choose to delay reconstruction until after they finish breast cancer treatment. Immediate or delayed breast reconstruction is possible in many instances after mastectomy.

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