TO CUT OR NOT TO CUT?

 Apart from the genitals, the chests of women bear these fatty tissues of different shapes and sizes that distinguish females from their male counterparts. They are at once symbolic of both femininity and of fertility. However, these same assets that any woman is proud to possess; that gets men all tongue tied and babies babbling with joy seems to be the very thing that brings grief, pain and possible loss of life to many.

Cancer of the breast accounts for about twenty-two percent of all cancers in women. It has existed for hundreds of years and has claimed the lives of many. Though the advancements in medicine have improved the survival rates, it is still one of the top ten causes of deaths in women.

Treatment options for breast cancer include chemotherapy, hormonal therapy, radiation therapy and surgical intervention. Surgical intervention includes mastectomy – which is the total or partial removal of the diseased breast tissue, and lumpectomy – the removal of the breast tumor, a procedure which conserves more breast tissues.

The key to fighting breast cancer lies in early detection so as to have the right treatment administered. Most women in developing countries however are diagnosed in the very late stages of the disease due mainly to lack of awareness about it (thus inability to self-examine breast for lumps) and certain barriers to health services.

“I will not have my breast cut off!” is an all too familiar phrase usually uttered by most women in the doctor’s consulting room that have had the misfortune of being told they have breast cancer. Surgical intervention with a combination of other non-surgical treatment is the protocol for dealing with breast cancer. The earlier the tumour is detected, and smaller the extent of spread, the less radical the surgical intervention.

A diagnosis of breast cancer just like any other cancer can be like handing a death sentence to these patients. It is a traumatic period in their lives where most women are caught in the dilemma of either having the breast cut off to save their lives or keep it so as not to feel “maimed” or “deformed” in the eyes of society, which option almost invariably leads to a painful and agonizing death. Somehow it is expected that these affected women should not even think twice about this decision, neither should it be up for discussion as a person’s life is more important than a pair of tissues on their chest.



Most women in almost every society on the other hand consider their breasts as what makes them “whole”. Having to undergo a mastectomy plagues them with myriads of questions such as – how would she look after surgery? Would her partner still find her attractive? For a single woman would she still be desirable to men? And if she ever gets married would she be able to have children? There is the option of reconstructive surgery (to minimize the emotional distress of losing a breast) but that is limited and very expensive in our part of the world.

There are some women who in the face of an overwhelming presence of the disease have persisted and “kept” their diseased breast “intact,” leading to agonisingly predictable results. Whilst others may have judged them as being stupid or reckless I would rather say they made a choice they thought best, owing to the emotional and psychological trauma they would have to deal with and the fear of being ridiculed by people. No matter how “unwise” their decision might appear, you would have to live through their situation to make any meaningful assessment of the issue.

It’s about time we educated ourselves more about the disease so as to meaningfully support those living with it. Family members and spouses need to understand and know that having breast cancer doesn’t change who your wife, mother, daughter or aunt used to be.

Angela Jolie, a Hollywood actress recently revealed that she has had a prophylactic double mastectomy performed on her owing to the fact that she had a genetic predisposition to having breast cancer. This decision of hers was highly discussed in the media with BBC’s popular World Have Your Say inviting breast cancer survivors to also share their stories. Central to most of the stories of these survivors was the fact that they had their cancer detected early; genetic testing made a difference and the decision to have a mastectomy to either deal with their cancer aggressively or reduce their chances of getting the disease.

Having such a prominent figure, more so an actress, whose physical appearance is a big deal in her line of work come out publicly with regard to her decision to have her breasts cut off so as to reduce her chances of getting the disease was more than an endorsement of the fact that there is still more to live for after being diagnosed with breast cancer and the decision to have a mastectomy performed.

It’s also about time as a nation we invested in centers to have people genetically tested for the disease to ensure early detection especially if there exists a family history of it. We need to step up our educational campaign and most importantly increase our National Health Insurance coverage for the treatment options for these patients.

To women out there battling breast cancer, I salute you. And to those who have survived it, you are heroes and an inspiration to others still fighting this disease.