Going through a cancer diagnosis can come with so much stress and uncertainty. Will the treatment work? Will the cancer come back? Will I be okay?
For women who undergo a lumpectomy or mastectomy to remove the cancer, their scars can serve as a daily reminder about what they’ve been through long after they’ve beaten the disease. While some women may see their scars as a symbol of bravery, the majority of women who have gone under the knife for breast cancer surgery say they feel “negatively affected” by the scars that remain.
“After surviving the trauma of cancer, many women must still battle with the psychological and physical consequences of both a new cancer diagnosis and its treatment,” said Dr. Jennifer S. Gass, chief of surgery at Women & Infants Hospital.
The good news it that there are surgical options that allow for minimal scarring.
However, one-third of women aren’t told about these options by their physicians.
Gass is the lead author of a study that sought to assess the impact of surgery scars on survivors. The paper, titled How do breast cancer surgery scars impact survivorship? Findings from a nationwide survey in the United States, was published in BMC Cancer on April 11, 2019. It is the first peer-reviewed, nationwide study to examine the negative relationship between scarring and breast cancer survivorship.
Gass and her team surveyed 487 breast cancer patients who had gotten a lumpectomy and/or a mastectomy.
The survey revealed that a full third of women weren’t told by their physician about scar-minimizing surgery options before the surgery took place. Two-thirds of those women would have considered the surgery had they been informed beforehand.
Researchers found that the majority of the women they surveyed were not happy about the location of their scars and were self-conscious about them.
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- 64% were not happy about the location of their scars
- 63% felt self-conscious about their scars
- 57% chose specific clothing that wouldn’t reveal their scars
- 60% were unaware how the scarring would make them feel when undressing
- 32% were not told by their physicians about surgeries with minimal scarring
- 6% felt minimal or no negative impact from their scars
- 67% were not happy about the location of their scars
- 77% felt self-conscious about their scars
- 66% chose specific clothing that wouldn’t reveal their scars
- 72% were unaware how the scarring would make them feel when undressing
- 35% were not told by their physicians about surgeries with minimal scarring
- 14% felt minimal or no negative impact from their scars
Why patients aren’t being told about all of their options is unclear. It is it a lack of expertise? A lack of caring? A lack of understanding about the impact scars have on survivors?
Gass posits that it may be because some surgeons simply don’t know how to perform these types of surgeries.
“Historically, incisions for cancer were placed directly over the tumor, particularly when the tumor was palpable. Now more cancers are detected by mammography and are non-palpable,” Gass said. “Smaller tumors require less extensive tissue removal, thus, resections that may have previously required skin do not today, and therefore incisions may be able to be placed remotely. This adds another level to the task of surgery, just as laparoscopy adds another level of skill to abdominal surgery. Therefore there may be a knowledge gap.”
Patients should feel empowered to be their own advocates, ask their surgeons about surgeries that reduce scarring, and spread the word that these types of surgeries exist.
But surgeons still needs to do their part and keep up-to-date on surgical procedures, especially when they can positively affect quality of life.
“Our findings illustrate how important it is for surgeons to ensure their patients are aware of the long-term impact of cancer surgery and how it will affect their bodies,” said Gass. “Patients should know if they might be candidates for surgical options that minimize morbidity. A surgical scar is a morbidity.”Whizzco