episode 9. The Mastectomy: Reclaim your power

The symbol of the breast is well known throughout society. Breasts symbolize sexuality, motherhood, femininity, and more. But what do breasts mean to women who lose them? In this episode, we explore the history of the surgical procedure of breast removal, the mastectomy, in the context of breast cancer. After discussing how this procedure came about, we discuss the difficult decisions that women face after this breast removal surgery. Considering all the societal pressures on what it means to have breasts, post-mastectomy patients are left with a big question: to reconstruct or to not reconstruct?? Join us in this episode as we explore some history, talk about modern mastectomies, and look at the emotional decisions women go through to reclaim their power over their post-mastectomy bodies. 

Feminist Corner

  • What do you think of the history of the procedure and what it is like today? Do you think they considered the wants and needs of the woman during the development of this procedure or in the procedure today? 
  • Based on the different reactions women have after mastectomy on how they view their feminity, how do you view femininity? Is it internalized misogyny to want reconstruction or is it reclaiming your power? What about choosing to not reconstruct? What does this tell us about the interaction between societal views of feminity and personal views? 
  • If you were faced with a patient who was considering a mastectomy and was worried about choosing reconstruction or not, how would you advise them?

Listen to the episode, discuss these questions with friends and family, let us know what you think!

Show Notes:

Today’s topic is the History of the Mastectomy! This is our first episode under the topic of medical procedures specific to women. However, it can be performed on men as well.  We chose to talk about the mastectomy because it is pretty well known as a female procedure and has a profound impact on the patients who receive it. And if you do not already know, a mastectomy is a surgical procedure that removes the breast tissue from the body, usually due to breast cancer. 

Our story begins in the history of breast cancer and the development of the mastectomy.

  • Ancient History 
    • In Egypt, there was mention in the Edwin Smith papyrus of multiple cases of the breast.
    • In Greece, the sick brought offerings to Asclepius in hopes of a cure. Hippocrates also theorized breast cancer was due to an imbalance in the 4 humours. 
    • Ancient Greeks named the disease ‘cancer.’
    • First couple mentions of removal and cauterization of tumors as a major form of treatment.
  • Advancements in the surgery take place.
    • German physician designed a device to allow more effect surgeries of total breast removal to take place
    • A better understanding of the structure of the breast and axilla (armpit) helped doctors understand the severity of the disease. 
    • Surgery involving removal of the entire chest was developed, though relatively uncommon.
    • Dr. Halsted published a paper detailing a safe and effective way to do a radical mastectomy called, “Halsed radical mastectomy.”

But what about the state of the surgery today?

  • Patients receive mastectomies when they are at high risk for breast cancer or when they have breast cancer. 
  • A variety of procedures can take placed now based on what is best for the patient and can be combined with radiation or chemotherapy.
  • During surgery, the breast tissue and lymph are always removed.

After women go through the mastectomy, they are left without breasts. But this doesn’t mean it is the end, they have some decisions to make.

  • Women are faced with the choice of how they want to control their lives and view their bodies.
  •  This decision can be difficult due to the social symbolism of the breast. The breast represents sexuality, motherhood, feminity and more. 
  • Women’s decisions come down to two things:
    • Reconstructive surgery.
    • Choosing to be flat.
  • Both decisions are completely up to the woman and there is no right or wrong decision. The women’s choice is her way of reclaiming her power over her body. 

Sources:

After mastectomy: Large study follows reconstruction patients for info on outcomes. (n.d.). Retrieved from https://ihpi.umich.edu/news/after-mastectomy-large-study-follows-reconstruction-patients-info-outcomes

Early History of Cancer. (n.d.). Retrieved from https://www.cancer.org/cancer/cancer-basics/history-of-cancer/what-is-cancer.html#:~:text=It’s called the Edwin Smith,“There is no treatment.”

Freeman, M. D., Gopman, J. M., & Salzberg, C. A. (2018). The evolution of mastectomy surgical technique: From mutilation to medicine. Gland Surgery, 7(3), 308-315. doi:10.21037/gs.2017.09.07

Lakhtakia, R. (2014). A Brief History of Breast Cancer Part I: Surgical domination reinvented. Sultan Qaboos University Medical Journal, 14(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997531/#b3-squmj1402-e166-169.

Navigating the Aftermath of Flat Denial ” Not Putting on a Shirt. (2020, August 06). Retrieved from https://notputtingonashirt.org/aftermath/

Pillai, M. S. (2017, February 19). The woman who cut off her breasts. Retrieved from https://www.thehindu.com/society/history-and-culture/the-woman-who-cut-off-her-breasts/article17324549.ece

Stavrou, D., MD, Weissman, O., MD, & Polyniki, A., MD. (2009). Quality of Life After Breast Cancer Surgery With or Without Reconstruction. EPlasty. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691644/.

Webb, C., Jacox, N., & Temple-Oberle, C. (2018). The Making of Breasts: Navigating the Symbolism of Breasts in Women Facing Cancer. Plastic Surgery, 27(1), 49-53. doi:10.1177/2292550318800500

Worrall, S. (2014, October 29). Amazon Warriors Did Indeed Fight and Die Like Men. Retrieved from https://www.nationalgeographic.com/news/2014/10/141029-amazons-scythians-hunger-games-herodotus-ice-princess-tattoo-cannabis/

Like the episode? Send us your thoughts and questions!

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