Changes to body image and sexuality
Breast cancer can affect how you feel about yourself (self-esteem) and make you feel self-conscious. You may feel less confident about who you are and what you can do. Give yourself time to adapt. Try to see yourself as a whole person (body, mind and personality) instead of focusing on the parts that have changed. Talking to your partner and learning to get undressed naturally in front of them may also help.
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Breast and areola appearance
You may find that having a breast reconstruction or wearing a breast prosthesis improves your self- confidence. Or you may prefer to not have a reconstruction and “go flat”. Areola tattooing can tattoo the look of an areola and nipple onto the breast following a mastectomy. Areola tattoos are typically done on breasts with implants, with and without nipple reconstruction. Or you may choose a decorative tattoo to cover scars. For some people this is a way to take control of their body and express themselves.
Breast cancer can also reduce your desire for sex (libido). You may miss the pleasure you felt from the breast or nipple being stroked or kissed during sex. This may be the case even if you have a reconstruction. If breast stimulation was important for arousal before surgery, you may need to explore other ways of becoming aroused.
Some treatments for breast cancer can cause vaginal dryness, which can make penetrative sex painful. For most people, sex is more than arousal, intercourse and orgasms. It involves feelings of intimacy and acceptance, as well as being able to give and receive love. Although penetration may not always be possible, closeness and sharing can still be part of your relationship.
After treatment you shouldn’t use any hormone-based contraceptives (“the pill” or hormone implants or injections). It is best to use condoms, diaphragms or intrauterine contraceptive devices (IUDs).
Podcast: Coping with a Cancer Diagnosis
A/Prof Elisabeth Elder, Specialist Breast Surgeon, Westmead Breast Cancer Institute and The University of Sydney, NSW; Collette Butler, Clinical Nurse Consultant and McGrath Breast Care Nurse, Cancer Support Centre, Launceston, TAS; Tania Cercone, Consumer; Kate Cox, 13 11 20 Consultant, Cancer Council SA; Dr Marcus Dreosti, Radiation Oncologist and Medical Director, GenesisCare, SA; Dr Susan Fraser, Breast Physician, Cairns Hospital and Marlin Coast Surgery Cairns, QLD; Dr Hilda High, Genetic Oncologist, Sydney Cancer Genetics, NSW; Prof David W Kissane AC, Chair of Palliative Medicine Research, The University of Notre Dame Australia, and St Vincent’s Hospital Sydney, NSW; Prof Sherene Loi, Medical Oncologist, Peter MacCallum Cancer Centre, VIC; Dr W Kevin Patterson, Medical Oncologist, Adelaide Oncology and Haematology, SA; Angela Thomas, Consumer; Iwa Yeung, Physiotherapist, Princess Alexandra Hospital, QLD.
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