Missing a Breast: The Impact of a Mastectomy

Excerpted from
Breast Cancer Husband: How to Help Your Wife (and Yourself) during Diagnosis, Treatment and Beyond
By Marc Silver

She still remembers the look. It was the first time he saw her chest after she came home from the hospital, minus one breast She was standing in the bathroom, getting undressed. Walking by, he caught a glimpse of what she calls, with sardonic humor, "the remains of the day." And she caught a look-"a flicker of distaste across his face." A "micro-expression" that lasted mere seconds, but an expression that she has never forgotten.

She knows that her chest was not a pretty sight. There was swelling and redness from the incision and the stitches. She had not had reconstructive surgery.

She never said anything to him. He never said anything to her.

He was her long-term, live-in boyfriend, who had stood by her during diagnosis and treatment, braving a blizzard to drive her to the hospital for her mastectomy and bringing her parents in from the airport to her home. In other words, he was more of a husband than some till-death-do-us-part husbands. But then came the look. The look was, as it turns out, a harbinger of bad things to come. Three years later, he did "the grand dump," as she puts it, and he gave her the impression that he would have walked out long before, only he couldn't just leave her right after she had been diagnosed with cancer. She can't quite believe he was really ready to say goodbye at that time. Not when she remembers how he hugged her when she was afraid, and how much that meant to her.

A few more years have gone by. She is healthy, and she looks good. She has moved on with her life. But looking back, she wonders: What if? What if, on that day of unexpected revelation, she had said to him, "What was that look for" or "It doesn't look too good to me, either." Instead, she was silent; and even now, she is haunted by the bitter memory of the look-and by the unspoken words that might have saved their relationship.

So, dear husband, don't let your stare do the talking for you. Especially in the aftermath of a mastectomy.

First Reactions

"Breasts are a big deal in America," says TV journalist Linda Ellerbee, who had a double mastectomy 12 years ago. "Just look around you."

The loss of a breast is a big deal, too. But there's no way to predict how your wife will react to the loss of a defining female part. Each year, about 101.000 women undergo a mastectomy, and I'd venture to say there are 101.000 different ways that the surgery plays out So a breast cancer husband has to be ready for anything. You may feel as if you are walking a tightrope over a pit of eggshells. Say the wrong thing (or say nothing at all), cast a judgmental glance ... and watch out.

The very thought of a mastectomy is enough to plunge some women into a wordless depression. That's what happened to my wife after we visited a surgeon who recommended a bilateral mastectomy. Marsha was cloaked in a raw and impenetrable sorrow. She retreated into herself. Nothing I said made a difference. I told her I loved her and not her breasts. She lashed out at me, "How would you feel if a doctor wanted to cut off your penis?"

My hands involuntarily traveled to cup my boys. And my wife wondered what to do about her girls, who had presented breast-cancer false alarms over the years, and now had betrayed her, as it were, by developing the real thing.

Needless to say, my wife's comments made me feel awful. After all, I was just trying to share what was in my heart. When I interviewed psychologist Anne Coscarelli, Ph.D. I asked her if I'd done something wrong. Her answer was, "No." It's important to express such feelings, says Dr. Coscarelli, who directs the UCLA Ted Mann Family Resource Center at the Jonsson Comprehensive Cancer Center in Los Angeles. She sees a lot of breast cancer husbands-not all of them, but a significant number-who tell their wives, "I don't care whether you have breasts or not. It's not your breasts I care about. I care about losing you. I love you and I want you in my life. That's the most important thing to me." But husbands need to understand that even such loving sentiments might not blunt the initial explosion of psychic pain. Many months later, I asked Marsha what I could have said or done to make a difference when she was feeling so blue. Her answer: "Nothing." She didn't want to hear, "There, there," or "It's not so bad."

She was grateful that I was by her side and that I hugged her and told her I loved her. "But even then, I still had to go through it," she says of her sorrow at the prospect of losing both breasts.

And I realized I was guilty of the crime of being a husband who wanted to fix things, to say the magic words that would banish Marsha's depression, when what I needed to do was to shut up and let her mourn the potential loss of her breasts.