78: A Woman’s Choice

78: A Woman’s Choice

From Chicken Soup for the Soul: The Cancer Book

A Woman’s Choice

Over my many years as an oncology nurse taking care of women with breast cancer, as well as my own personal diagnoses in 1992 and 1994, I have come to appreciate the importance of assessing a woman’s feelings about her breasts before surgery. As part of this assessment, when first talking with a patient about her diagnosis and treatment plan, health care providers need to learn about each woman’s relationship with her breasts.

How a woman reacts varies. One woman may say, “Take them both off. They don’t mean anything to me.” Another may say, “Will I have a scar on my breast after the lumpectomy? Will it be visible in the mirror when I look at myself?”

I often ask patients, “Tell me what you recall about the first time you were fitted for a training bra? Good experience or bad? How important are your breasts when you are intimate with your partner? If you were asked to rank your physical attributes, where do your breasts fall in that ranking?”

As a health care provider, this information can lend valuable insight into how well a woman is likely to cope with her upcoming surgery. Understanding a woman’s feelings beforehand may help in her subsequent treatment. By anticipating reactions, you will be more successful at treating the whole person and not just the disease.

Facing my own diagnosis of breast cancer, I was no different than most patients.

I quickly discovered that having 44Ds on my chest affected part of my self-image. I faced mastectomy without the option for reconstruction—at age thirty-eight and again at forty. If it weren’t for my husband teaching me that I needed to look at the surgery in a different way—as transformative surgery—I don’t know how I would have managed things psychologically. He said the surgery would transform me from a victim into a breast cancer survivor.

After my surgery, I focused on being optimistic and was thankful that my life was being spared. I also learned that a woman’s femininity is as much in her mind as it is in her silhouette. It is not based on breast ducts, lobules, and fat cells. However, having the privilege of being reconstructed ten years later reaffirmed for me that my psychological well being, though healthy, could be made better by restoring that which I lost to cancer a decade before.

A woman’s relationship with her breasts influences her decision making about her breast cancer treatment, her emotional well being during and after treatment, and for that matter, perhaps even how much she fears getting this disease to begin with.

Culturally, as a society, we need to take a different approach when teaching our children and grandchildren more about self-image. The values we impart should be tied to self-respect and the feminine strength that womanhood should represent.

A woman facing a diagnosis of breast cancer ought to inform her surgical oncologist and oncology nurse about her relationship with her breasts. Participate in the decision-making. Be sure the type of surgery you choose also addresses your psychological well-being. We each have the right to choose after careful thought, education, and planning. A year after a woman completes her treatment, I want to hear her say, “I’m happy with the treatment choices I made.”

~Lillie D. Shockney, R.N.

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