Breast removal: Busting the myths around it

Breast removal is a defining moment for a woman who has undergone mastectomy. From identity to sexuality, from womanhood to motherhood, several notions are intertwined with the female breast. And yet, like many other significant issues, this one finds little space in public discourse, writes Mallika Iyer 

“When a woman has lost her nipples, her ears with their earrings, her nose like a vine… isn’t her beauty destroyed?” Soorpanakha demands an answer from Rama, after Lakshmana has mutilated her by cutting off her nose, ears and breasts. A turning point in Kamban’s Tamil Ramayana (Iramavataram), in distinction from Valmiki’s Ramayana, where Lakshmana cuts off only Soorpanakha’s nose and ears.

Cultural moorings

Soorpanakha is not alone in suffering the loss of a breast in our legendary lore. Two other Tamil heroines – Goddess Meenaxi and Kannagi of Madurai too, find themselves in stories where the loss of a breast signifies something significant. The warrior princess Meenaxi is born with three breasts. She loses her third breast upon meeting Shiva, her destined husband, signifying a transformation from warrior to woman. Such is the story told in the Tiruvilaiyadal Puranam. The tale of Kannagi, drawn from the Tamil epic Silapathikaram, stands on a different footing. There, Kannagi tears off her own breast as a mark of protest and throws it upon the city of Madurai to bring about its destruction. Similar stories can also be found in other cultures, notably the women warriors of the Amazon, who were known to cut off their breast to become better warriors.

Literature mirrors societal norms and attitudes and it may do well to ask what the significance of the breast is in a cultural context. Revered for its lactating ability to sustain life, the breast is a symbol of motherhood. It is also a symbol of femininity, masculine desire and sexuality. From breast implants to breast pumps, it has given rise to several modern-day industries.

Its significance is particularly highlighted for a woman who has lost a breast due to cancer.

Personal stories

Patients who have undergonea mastectomy, with partial or complete breast removal often grapple with their permanent change in appearance. The subject of cancer, more so related to a private body part being largely taboo, not many are willing to talk about what the loss of a breast means to them.

“Knowing that one has cancer is in itself a traumatic experience. Over and above that, patients feel a loss of identity when they lose their breast,’’ explains Dr Seema Hingorani, city-based clinical psychologist and trauma expert. “The inability to freely express and talk about that, adds to the trauma leading to depression.”

For many women, the breast means femininity, beauty and motherhood and its loss results in negative feelings about appearance. “I was very beautiful and loved to dress up,” says Neha Kishore Patkar, a breast cancer survivor. “I am strong-willed and kept my head up through every struggle in life from the death of my daughter to battling cancer,” she explains. Yet, she was haunted by the change of her appearance.

“I dreaded looking into the mirror,” she rues. “One breast had been cut off and I lost all my hair. It was awful.” But that did not deter her from dressing up or socialising. “I refused to let that bog me down. I went for weddings. I went out. If people stared, it did not bother me because my husband supported me and my son gave me a reason to live with my head held high,” she says cheerfully.

And women like Patkar, have now found support in the apparel industry, which is responding to the need of these women with style.

Appearance matters                          

After mastectomy, women often prefer clothes that mask the lack of a breast. From the very first encounter with the surgical area to a lifetime of living without a breast, feelings of self-consciousness and psychological problems associated with being deformed and incomplete trouble them. “Although my mother took cancer in her stride, the change in appearance did bother her. She was accustomed to looking dignified as a school principal. And she did not want that to change,” says Poornima Arun, who lost her mother to breast cancer.

One area in which the loss of breast is a constant reminder is clothing adjustments. The patient feels the need to hide the new reality by wearing loose fitting garments or padding-up the affected area, to prevent others from staring.

In the news recently, was a New York Fashion Week Show where breast cancer fighters were honoured with designs meant for them. Apparel makers are taking notice and outfits with soft padding, extra layering, cushioned straps and other specific needs of breast cancer patientsare slowly emerging. Marks and Spencer swung into action when its CEO, Sir Stuart Rose, received a letter from a customer in 2006 regarding the absence of lingerie for breast cancer patients.

“My team and I were challenged to create the same beautiful, feminine lingerie for women who had undergone mastectomy,” says Soozie Jenkinson, head of design for Lingerie, Active and Swim at  the companyThey started by talking to patients to understand their needs and expectations. Comfort, support and femininity were all crucial to the design. “The resulting range successfully brings together these findings whilst considering factors such as functionality, discreet pockets designed to hold the prosthesis firmly providing body confidence,” explains Jenkinson. The line of lingerie for mastectomy patients is also available now in India.

Other apparel makers are also taking note and gearing up. But it is a long journey before the subject comes out of the taboo mode.

“Unfortunately, one is conditioned to associate shame with certain parts of the body,” explains Poornima. “That deters people from discussing issues openly, hampering early detection and diagnoses – which can be life-saving.” Surveys have also found that women see the breast as a symbol of maternity and delay seeking medical help because it affected their image of being able to look after their families.

Globally, breast cancer is the leading cause of cancer deaths. It is also the most common cancer detected in Indian women. And yet, many issues related to it are brushed under the carpet, under overbearing notions of shame and social stigma.

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