Breast cancer accounts for one in three new cancers in women. And in recent years, more and more people have opted for mastectomies as treatment options.
While it may seem like someone having their breasts removed is a quick path to breast cancer recovery – or prevention – a mastectomy is an incredibly emotional experience. If you know someone in your life who has had one, you will likely want to comfort them. You may also be curious about what someone else has gone through with their procedure and want to ask some questions, like whether they are planning to have reconstructive surgery.
But experts and patients warn that a mastectomy is a topic that should be handled with sensitivity. Saying the wrong thing can be stressful for a patient who has already endured so much. Here are a few things to avoid saying when talking to someone who underwent the procedure:
‘Are you getting new boobs?’
Not every person who undergoes a mastectomy will choose to have cosmetic reconstruction.
“Some patients may elect to ‘go flat’ – sometimes called an ‘aesthetic flap closure,’” explains Dr Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center. “Do not assume that mastectomy patients will choose a cosmetic reconstruction to resemble their original breasts.”
‘At least you got a free boob job.’
“A mastectomy is nothing like a breast augmentation,” says Alex Whitaker Cheadle, a publicist in Kansas City, Missouri, who underwent a double mastectomy. “It’s quite literally an amputation of your chest and visual/aesthetic results vary from patient to patient.”
She added that even for those with the best aesthetic outcomes, it’s an extremely emotional and life-altering procedure, not to mention invasive.
“I had a nipple-sparing double mastectomy over four years ago and still suffer from physical side effects that impact my daily life – far from your average ‘boob job,’” Cheadle says.
“Despite hating when people say this, I do believe it’s a go-to phrase because it comes from a good place,” she adds. But she’d much prefer friends and family simply ask how she’s doing: “It really is as simple as listening.”
“When I open up to a loved one about my surgeries, it takes a lot, so hearing something in return like, ‘I still hate that you went through that. How can I support you?’ is so much better than hearing something that comes across as minimizing the real pain and tough emotions I’m still working to process.”
‘Well, now you will never have breast cancer again.’
Another assumption that can translate into unhelpful, and untruthful, comments is the idea that a mastectomy means a person can never get breast cancer again, Comen says. She stressed that “breast cancer can still, albeit rarely, recur in the chest wall where the original mastectomy was performed.”
“Even after a mastectomy, some patients may be diagnosed with metastatic breast cancer, or breast cancer cells from the original breast cancer that spread outside the breast to other parts of the body,” she explains.
‘At least they caught it early.’
“While some people have mastectomies and avoid treatments like radiation and chemotherapy, this is an incredibly invalidating statement for the life-altering and painful surgery they’ve just experienced,” explains Tamika Simpson, a perinatal mental health specialist with Ovia Health.
Simpson suggested following your friend’s lead when talking about the procedure and voicing your support for what they did experience when the topic comes up.
‘My cousin/aunt/etc. had a mastectomy and you can’t even tell.’
“Comparison statements are rarely helpful when dealing with such a personal and painful situation,” Simpson says.
She adds that it might be helpful to offer some insight from a close friend or your own experience but still leave room for your loved one to talk about their own. Try, “I know I felt ___ when I had my mastectomy. Do you want to know what helped during my recovery or is that too much right now?”
‘Well, at least you don’t have to get a mammogram again.’
“Although this can be said in jest by a friend or family member ― and there may be some truth to it – it can also be very hurtful as it is a reminder of the loss that was encountered,” says Stacey Aaron Domanico, a two-time breast cancer survivor.
Statements like this, she added, are “a reminder of a body part that we did not choose to lose. Most women who have had mastectomies would gladly trade the once-a-year annual uncomfortable exam for the alternative.”
‘Does your partner like your new boobs?’
Avoid asking how a patient’s significant other feels about their mastectomy because it’s (a) an intrusive question and (b) possibly something the person is already feeling insecure about, says Dr Claudia Cotes, an assistant professor at the McGovern Medical School at UT Health Houston and chief of breast imaging at Memorial Hermann Health System at the Texas Medical Center.
“It is normal to be self-conscious after this procedure,” she said. “Additionally, it is their body, and not their partner’s.”
‘You have the perfect body/breasts.’
“I had an incredible plastic surgeon, and the truth is no one can usually tell, even in fitted dresses or bathing suits,” explains Sally Joy Wolf, a stage 4 metastatic breast cancer thriver in New York City. “But to say no one can tell is to deny an incredibly important and ongoing part of my life journey.”
Wolf added that her scars are a part of her, and they go beyond the physical body. “I also have found much post-traumatic growth in this journey, and cancer finally gifted me permission to choose vulnerable over perfect,” she explains. “Comments like these often seem to be more about the giver – their perception and/or a reflection of societal norms – than about me and where I am.”
‘What size did you get? Did you go bigger?’
“It is a misunderstanding that you can just remove your breasts and then decide on what size implant you get,” explains Kelly Crump, a model who showed off her mastectomy scar in this year’s Sports Illustrated Swimsuit Issue and the first model with incurable cancer to be shot for the magazine. “It does not work that way, as there are many limiting factors as to what the reconstructive surgeon can do post-mastectomy.”
Crump says it’s important to “remember that a mastectomy, with or without reconstruction, is a major surgery in which a visible body part is fully removed. Therefore, keep it supportive and real.”
These types of comments, she says, can be far more helpful:
- “How are you feeling post-surgery? I am here to listen if you need to talk about it.”
- “Post-surgery I can help you with ___ so that you are able to rest. Just know I am here to help you so you can recover as best as possible.”
- “I can’t imagine what you are going through but I want you to know I am here to ____ (listen/support/hug/help/etc.) and just know I care about your well-being.”
‘Can I see them? Can I touch them?’
Asking to see or touch someone’s boobs in any scenario is never OK, post-mastectomy or post-reconstruction included.
“Just because they are not their natural breasts, their reconstructed breasts are still theirs and it is very inappropriate to ask to see or touch them!” says Dr. Beth Baughman DuPree, chief medical officer of Innerstill Health, Caliber Medical and Gateway Sciences.
‘Why did you get a mastectomy?’
Don’t question why someone got a mastectomy. The decision to undergo a mastectomy is medical, but it’s also personal, says Kathy Giusti, co-founder of the Multiple Myeloma Research Foundation and co-chair of the Harvard Business School’s Kraft Precision Medicine Accelerator.
“Thanks to modern science, people often have several options for treatment and use the guidance of their doctors, family and friends to inform their decision,” says Giusti, who recently underwent a double mastectomy. “Every person is different, there is no one-size-fits-all for a treatment plan. Be open to listening if they offer, and don’t be judgemental. But assume the person made the decision that is best for them.”
‘You’ll feel back to normal within a few weeks of surgery.’
Downplaying the surgical and psychological pain associated with a mastectomy minimizes the patient’s feelings, says Dr. Kelly Hunt, chair of Breast Surgical Oncology at The University of Texas MD Anderson Cancer Center.
While mastectomy patients may feel physically well within a few weeks of surgery, the emotional recovery can take considerably longer. “Adjustment disorders are common in all cancer patients, particularly breast cancer patients undergoing image-altering surgery,” Hunt says. “Do not assume that once a patient’s active cancer treatment is over that the recovery is complete.”