Elective mastectomy—what I wish my doctor had told me.

The diagnosis of breast cancer brings with it an avalanche of decisions, and one of the most difficult is whether or not to remove the unaffected breast. Our hope is that getting rid of the breast will protect us from recurrence, and with advancements in reconstruction, we can look forward to perky, cancer-free breasts. Good as new.

Right?

Not really.

No one cautioned me about the impact of nipple amputation on my sex life. No one even mentioned sexual function in any way. I know, it should be obvious that no nipple equals no pleasure. But such obvious things are exactly the kinds of things that don't occur to us when we are scared to death of dying.

When men have prostate cancer the top question they ask is, you guessed it, "Will I retain sexual function?" And a huge percentage of men opt for the less invasive, more risky, treatment in order to preserve quality of life. Why is sexual function not considered an important issue when choosing breast cancer treatment, particularly elective mastectomy?

It never occurred to me, and no one warned me. In all of my research I have never found a woman who was told about the cost of nipple amputation. Some women say, "I wouldn't miss it. I haven't felt my nipples since I breast fed." Others say, "It would be a devastating loss." The point is informed consent-- hear the pros and cons, and make the choice you can live with.

Of the dozens of women with whom I have spoken since my surgery, only one said that someone brought up this issue with her prior to surgery. That is unconscionable, so I make sure to explore the subject with women who contact me. I want to be part of the solution, not just complain about the problem.

I wish someone had done so for me.


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