When Léa learned that she had to have a mastectomy, her first thought was about her survival. “I just wanted the cancer to go away“, she says. But a few weeks after the operation, the shock was more subtle, more intimate. Looking in the mirror had become a painful ritual. This experience is not isolated.
Mastectomy: saving life at the cost of an intimate injury
Behind the promise of healing, mastectomy often hides an intimate shock. Yale surgeons are calling for better preparation of patients for the psychological and sexual consequences of this operation.
According to a large study led by Dr. Lauren Raymond-King, resident surgeon at the Yale School of Medicine, women who undergo mastectomies are at greater risk of emotional, sexual and body image problems than those who receive breast-conserving surgery. Presented at Clinical Congress 2025 of theAmerican College of Surgeons (ACS)this study highlights the importance of preparing patients for all dimensions of the ordeal, beyond the operating room.
“As surgeons, we often focus on the medical side of care. There is no one-size-fits-all approach to counseling women about the full range of physical and emotional consequences of a mastectomy.”explains Dr. Lauren Raymond-King.
Many patients therefore approach the operation with an incomplete understanding of what it involves in the long term – not only physically, but also psychologically.
When surgery affects the intimate: sexuality and self-image
Léa is not alone in this journey. The systematic review retained 20 studies out of nearly 3,000, all involving women with stage 1 to 3 breast cancer. Fifteen of them reveal more unfavorable psychosocial outcomes after mastectomy.
The most frequently evaluated areas: body image (55%), sexual health (50%), pain or physical function (45%)And quality of life (40%). This multiplicity of dimensions shows to what extent the impact of surgery goes beyond the strict medical framework.
“Now there are many more breast cancer survivors. We cannot miss the opportunity to study their quality of life, since these women live much longer after their diagnosis and treatment.”underlines Dr. Elizabeth Bergerprofessor of surgery at Yale and co-author of the research.
According to the American College of Surgeons Cancer Program 2025 Annual Report, 34% of breast cancer patients between 2018 and 2021 underwent a mastectomywith a average length of hospital stay of just one day. This speed, while it meets the requirements of medical care, sometimes leaves little room for psychological, sexological or aesthetic support.
Emotional reconstruction: a step still too often forgotten
Today, Léa participates in a post-mastectomy support group. She finds other women there, who talk about their doubts, their anger, their loneliness. “We talk about visible scars, but no one prepared us for the scar of the soul”she confides.
Yale researchers offer a concrete solution: develop a standardized emotional and psychological screening toolto assess patient preparation before surgery. Currently, 38 different tools are used, with wide variation in patient-reported results, complicating overall management.
A validated tool could make it possible to anticipate needs, adapt support and reduce post-operative disorders. Beyond the surgical technique, it is about preparing each woman for rebuild yourself fullyby reconciling medical survival and psychological balance.
Towards a more humane medicine
This awareness is a turning point. Mastectomy is no longer just a question of survival: it involves the identity, sexuality and daily lives of patients.
For Dr. Raymond-King and her colleagues, the future lies in psychological preventionthere transparent communicationand person-centered post-operative follow-up. Because behind each number hides a life, a body and a spirit to support.