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October 22, 2019
In this op-ed, Dr. Anne Peled, MD, a board-certified plastic surgeon practicing aesthetic, reconstructive, and breast cancer surgery in San Francisco, discusses how the prospect of breast numbness after a mastectomy can prevent patients from seeking this life-saving treatment — and how there are new techniques to help preserve sensation.
One out of every eight women and about one out of every 800 men in the U.S. will develop breast cancer in their lifetime, according to the National Cancer Institute. Many people diagnosed with breast cancer opt for a mastectomy, as will many people who know they are at high risk for breast cancer in the future due to their family history or genetic mutations and want to reduce this risk. And while mastectomy is a life-saving measure, few people talk about the after-effects, especially the psychological ones. Through my work as a breast cancer and reconstruction surgeon, as well as having gone through breast cancer treatment personally, the one thing I continue to be struck by is how a mastectomy can negatively affect a person’s sense of self and relationship to their body — and how there are new treatment options to minimize these effects.
At the time of a breast cancer diagnosis, considering treatment options can be very overwhelming. The initial, understandable urge for many people is to just “get the cancer out,” without as much consideration for the potential impact that the treatments may have on them later. Fortunately, we have come a long way in providing many different treatment options for patients. Many breast cancer patients are now offered newer breast reconstruction options and nipple-sparing mastectomy (NSM) approaches, and while these procedures provide excellent aesthetic outcomes, they also unfortunately come with a major downside: loss of breast and chest sensation.
Most people making the decisions around mastectomy don’t realize that the procedure will leave them with little, if any, sensation in their breast or nipple skin after surgery. In one 2018 study, only 2% of women gained full sensation in their breasts after a mastectomy. While this fact is sometimes discussed during surgical consultation, many people are surprised to find out that they have lost sensation after surgery, and are then even more shocked to find out it’s often permanent.
