One of the most difficult aspects of preparing for a mastectomy is getting emotionally ready. It’s hard to predict how you will react after the surgery, how it will make you feel, and which emotions will dominate. Despite the trauma and seriousness of the surgery, many women I have coached, express a sense of relief afterwards. They often say, “It’s gone, I’m happy it’s gone. I feel less stressed, I worry less and I’m less afraid of a recurrence”. This feeling of a weight being lifted is a reality that sometimes only those who have gone through it can truly understand. Other women experience a deep sense of loss, and struggle with body image, self-confidence and intimacy.

In terms of post-surgical trauma, my experience has shown that the better the aesthetic result, the better women cope with the change in their bodies. Fortunately, significant progress has been made in breast reconstruction, and many reconstructions turn out beautifully. However, the type of mastectomy you are a candidate for—whether it is a conservative mastectomy, skin-preserving mastectomy, nipple-preserving mastectomy or radical mastectomy—depends on various factors.

Mastectomy requires some practical preparation for post-surgery, including: 

• Clothing: Bring the right clothes to the hospital. After a mastectomy, it can be painful to lift your arms, so opt for clothes that button or zip up the front, which you don’t need to lift your arms to put on or take off.
• Bras: The right bras are also crucial. Surgical bras are often provided by the hospital, but make sure you buy some bras for post-surgery. Choose non-wired bras that provide enough support, are comfortable and ideally are 100 per cent cotton.
• Movement and physiotherapy: Mastectomy can limit your range of movement, especially of your shoulders and arms. Yet, movement is crucial for recovery. With your doctor's approval, it is important to start moving as soon as possible after surgery, but under proper guidance for optimal recovery. Find a physiotherapist who is trained in mastectomy recovery and who can work with you as soon as possible after surgery. Understanding which movements are allowed and which are not is crucial. Many women fear pain or injury and avoid moving their arms, but movement is essential for regaining range of motion and preventing long-term stiffness.

The psychological and emotional aspects of recovery are often the most complicated. In my professional experience, I have seen that they usually depend on two factors: the aesthetic look and the individual’s attitude and mindset. These are not always easy to control, and it’s important to approach the topic with deep respect and without judgement.

Some women look in the mirror and see a scar, a reminder of their trauma and loss. Others see it as a symbol of survival and a second chance at life. Many women fall somewhere in between these perspectives. Discussing these feelings and ensuring women have safe spaces to address their thoughts and struggles is important.

The attitude of partners also plays a significant role in recovery. How partners react, treat and interact with women post-mastectomy can have long-term impact. It’s important for partners to have their own space for guidance and support, as the experience affects them too. Most partners are thoughtful and want to be respectful and supportive but may be uncertain about what to say or do.

Effective communication with your partner can make a significant difference. It might take time to feel comfortable discussing these sensitive topics, but the more you can talk about your feelings, the easier it will become for both of you.

Sometimes, working with a professional as a couple can be helpful. A mediator can facilitate discussions when conversations don’t flow as smoothly as you’d like.

Mastectomy is a very delicate, sensitive, personal and intimate topic and it’s imperative to be mindful when discussing it. Some women feel comfortable talking about their mastectomy experience, while others prefer to keep it private and feel extremely vulnerable when asked about their surgery.

I’ve heard too often from my clients about insensitive and intrusive questions that make them incredibly uncomfortable. Before asking someone if they’ve had a mastectomy, consider how such a question might affect them—it can trigger trauma or be perceived as an invasion of their personal space. Always let the person take the lead in these conversations. 

While there is a need to discuss the topic of mastectomy to educate women on their options to ensure they feel less isolated and to break the stigma around mastectomy, it must always be done in a safe environment with respect for the feelings and privacy of everyone involved.

This story is part of Front & Female's series She Speaks, through which we aim to drive open, inclusive and unfiltered conversations tackling the sensitive topics that impact women.

Isabel Galiano is a two-time breast cancer survivor and cancer coach who works with patients during and after treatment to provide support so they can better cope with both the physical and emotional challenges they encounter at each stage of a cancer journey.

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