SHE had her first mastectomy in 2011 after being diagnosed with breast cancer. A 36-year-old entrepreneur in the events industry,Shalini Ghatge (name changed) was traumatised dealing with men on a daily basis,the lack of one breast had dented her confidence although she would regularly use an imported prosthetic piece to cover up. I was all of 33 when I had to undergo a mastectomy I had been married for four years but was still building my career. I couldnt get myself to tell people,barring members of family,of what I had gone through because it inadvertently made them look towards my chest, says the Mumbai resident.
However,Hollywood star Angelina Jolies disclosure of the double mastectomy procedure as a measure to reduce the risk of breast cancer,has made her question her own insecurities. The fact that she chose to speak about it even though she is in a profession where looks and confidence matter the most,is encouraging. It makes me wonder if my fears were exaggerated, says Ghatge.
The stress of undergoing a mastectomy preventive or curative is not physical alone. While the process and treatment saps the patient of all his energies,the thought of battling the disease adds to the stress. This,however,grows manifold when the patient ends up losing one or both breasts. It is akin to losing a limb, says Dr Vani Parmar,professor of surgical oncology at Tata Memorial Hospital,Mumbai.
While it may be easy to attribute the lack of confidence following a mastectomy to ones vanity,Margaret Mascarenhas explains that the matter isnt limited to appearance alone. The 42-year-old who underwent her second mastectomy last month,has been wearing a prosthetic blouse since her first procedure two years ago. While it covers up well,the blouse has done little to make up for the loss she feels within. Due to popular culture,breasts have come to be viewed as a sensual element of a womans body; it defines our gender. Also think of the women who lose their breast/s before childbirth, she says.
With a rise in awareness regarding breast cancer and mastectomy,women are increasingly opting for prosthetics that would avoid undue attention to their state. However,the lack of facilities in India made designer duo Shivan & Narresh launch mastectomy blouses that can be made available with chemists in cities and through NGOs in villages and small towns. The duo has launched three varieties of blouses in standard Indian sizes while one uses light polyfill fibre,the other is made with soft,silicon substance. The third is a customised service offered at their store where they incorporate the prosthetic for clients everyday needs,including clothing items such as party dresses,corsets and swimwear.
Recounting his experience while working with women for designing the blouses,Narresh Kukreja says that the psychological impact of a mastectomy in his opinion varies based on their age and physical attributes. He recounts having met a woman in her 50s who was on the heavier side. To her,the lack of a breast also caused balancing issues although her self-image wasnt as affected as in the case of the one in her 30s. The lady in her 30s had recently married and one of her chief concerns was settling into a new family who may not understand her issues, he says.
Clinical psychologist and trauma expert Seema Hingorrany believes that the effect of mastectomy differs also based on the support the patient receives from family and friends. It is as much about education and awareness as about acceptance from the social setting the patient comes from. A woman I treated in her 30s coped better with the loss than one in her 60s,who herself nurtured old-fashioned values and refused to step out of the house or meet anybody after the surgery.
Jolie,however,is opting for a reconstruction of breasts using transplants. In an alternative procedure,the patients body tissue is used to develop partial and full breasts. In her sphere of work,it is a boon. Renowned Kuchipudi and Bharatnatyam dancer Ananda Shankar Jayant,too,opted for a similar procedure in 2008 when she was diagnosed with breast cancer.
The possibility of the latter,says Parmar,depends on the availability and feasibility of tissue. But such procedures do leave scars on the body. But one hopes that Angeline Jolies decision to speak about her double mastectomy will help get rid of the taboo, she says.