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    Psychological Issues of Breast Cancer

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    Worldwide, breast cancer is the leading cause of cancer death in women and in Chile it ranks second. We present an aging of the population which has influenced the rates of this disease, where the increase has occurred in ages over 50 years and especially over 60, which corresponds to the age groups that have increased in the population. The increase in the last decade has been 35% in our country.

    The body is an essential portion of our identity. Thus, each person attributes value to their integrity and indemnity, which influences the way in which they face certain diseases, surgeries or removals. This assessment is related both to the biological functions of the affected organ and to personal self-assessment. The breasts perform several interrelated functions, where in Western culture anyone who is affected influences this personal perception of this organ. The breast fulfills the nutritional function, since it produces one of the foods richest in nutritional properties, which is supplied mainly through the lactation period; the psychological function of breastfeeding, since through it, attachment, bonding and the delivery of affection to the child are favored; Identifying function of the female sex, since breast development marks the difference between the male and female body, constituting for the female sex, according to various studies, one of the most significant secondary sexual characteristics and an essential symbol of femininity; Erogenous function for both men and women, representing one of the most important sources of affective-sexual gratification.

    By virtue of this is that breast cancer is a stressful situation in women who suffer from it because if they have to face radical surgery, they must adapt to the changes in their body image and the feelings and attitudes that this entails.Importance in the field of motherhood, sexuality and physical attractiveness that the mother has in our society. For this reason, with the therapeutic advances in the management of breast cancer, in addition to improving the technique of mastectomy or breast removal, organ-conserving techniques have been explored and reconstructive surgery has been occupying a fundamental place in the management of breast cancer mother.

    Some type of surgery is used in most women with breast cancer. Depending on the type of breast cancer, the woman’s age, its location, the type of cells involved, removal of the tumor or a part of the breast may be considered, which is called conservative surgery. This technique is usually accompanied by radiation therapy or other complementary treatment. In other cases, complete removal of the breast by mastectomy is considered, involving the gland, much of the skin of the chest wall, and nodules. It can be considered in one or both breasts, depending on the woman’s history and course of the disease.

    In many cases, the immediate and permanent physical sequela of a mastectomy, depending on the context in which it was performed and whether it was unilateral or bilateral, is mutilation. This causes different conflicts, depending on the meaning that the woman gives to the breast. Through the accounts of mactectomized women, in an investigation by Pires & Norbe, it was found that the breasts express eroticism, sensuality and sexuality, and that this conception is valued by women in a significant way. Hence, when faced with the loss of a breast, psychological consequences are evident that drastically affect self-image. Other studies have shown that the greater this physical and visual deformity, the higher the probability that psychological and social adaptation problems will develop.

    All surgical procedures for breast cancer can be associated with different side effects that in one way or another affect a woman’s quality of life. Conservative surgeries offer a better body image for some women, however for others; they can be associated with more anxiety and greater fear of tumor recurrence. On the contrary, radical surgeries give more peace of mind in some cases, while in others it can represent a serious alteration of the body image that generates a problem of self-esteem and leads to psychological disorders that impact on the quality of life. It has been observed that the mastectomy initially reassures the woman by the liberating idea that all malignant tissue has been removed, but later there are reactions of depression and anxiety, concern about body image.

    The woman who is diagnosed with breast cancer suddenly finds herself faced with a new and unexpected situation, she is afraid of an early death, she is afraid of surgery and she is afraid of having to face a life that will be different. Survival rates for breast cancer have increased significantly, especially in young women, so improving this quality of life is a priority. A few decades ago, when faced with early-stage breast cancer, the management was radical, today, not only is the type of lesion analyzed in biological, clinical, and molecular aspects, but the profile of the woman influences in some cases the therapeutic decisions and Thus, defining what type of surgery will be performed? Will there be support from adjuvant therapy? And ultimately, what type of therapy is the most appropriate? Yes, Adequate information and support from the team of professionals accompanying the woman and the family is essential. Body integrity is threatened after cancer diagnosis, so maintaining an always fragile balance is important and significant.

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