Department of Nursing, Umeå University, Sweden.
Cancer Nurs. 2012 Sep-Oct;35(5):E41-8. doi: 10.1097/NCC.0b013e31823528fb.
Because of early detection and advanced treatment options, more women with breast cancer survive after mastectomy and thus have to face the choice of living with or without a reconstructed breast for many years to come.
This article investigates these women's narratives about the impact of mastectomy on their lives, as well as their reflections on breast reconstruction.
Fifteen women were strategically chosen from a previous population-based study on mastectomy. They were contacted for further exploration in thematic narrative-inspired interviews 4.5 years after mastectomy.
Three types of storylines were identified. In the first storyline, the mastectomy was described as "no big deal"; losing a breast did not disturb the women's view of themselves as women, and breast reconstruction was not even worth consideration. In the second storyline, the women described the mastectomy as shattering their identity. Losing a breast implied losing oneself as a sexual being, a woman, and a person. The third storyline fell in between the other two; the sense of femininity was wounded, but not to the extent that they felt lost as women.
Our findings suggest that the experience of mastectomy due to breast cancer is very much individual and contextual. Losing a breast may be of minor or major importance.
Healthcare practitioners should be attentive to how the women themselves experience the personal meaning of losing a breast and guard against vague preconceptions based on the breast-sexuality-femininity discourse and its connection to what the patient needs.
由于早期发现和先进的治疗选择，越来越多的乳腺癌女性在接受乳房切除术后面临生存问题，因此在未来许多年中都必须面对是否重建乳房的选择。
本文调查了这些女性对乳房切除术对生活影响的叙述，以及她们对乳房重建的反思。
从之前的一项基于人群的乳房切除术研究中，选择了 15 名女性进行了战略选择。在乳房切除术 4.5 年后，对她们进行了主题叙事启发式访谈，以进一步探讨。
确定了三种类型的故事情节。在第一个故事情节中，乳房切除术被描述为“没什么大不了的”；失去乳房并没有扰乱女性对自己作为女性的看法，而且乳房重建甚至不值得考虑。在第二个故事情节中，女性将乳房切除术描述为粉碎了她们的身份。失去乳房意味着失去自己作为性存在、女性和人的身份。第三个故事情节介于前两个之间；女性气质受到了伤害，但并没有到她们感到失去女性身份的程度。
我们的研究结果表明，乳腺癌导致的乳房切除术的经历是非常个体化和情境化的。失去乳房可能是重要的，也可能是不重要的。
医疗保健从业者应该关注女性自身如何体验失去乳房的个人意义，并警惕基于乳房-性-女性气质话语及其与患者需求的联系的模糊先入之见。
