Body image & sexuality

Many cultures closely link breasts to what it means to be a woman. Breasts can also have a role in sexual pleasure.

Physical changes to your breasts and body from breast cancer treatment may affect how you think about your overall self – your body image. Changes in your body image may negatively impact your emotions, self-confidence, sense of yourself as a sexual being and your relationships.

It can be hard to adjust to looking different than you did before. This effect may be even greater if you had poor body image before diagnosis.

How treatment affects body image

Breast cancer treatment causes several physical changes that may lead to body image concerns.

• Scars. Surgical scars may be visible reminders of what you have been through and cause you to worry about your attractiveness. You may feel less sensation in your breast area as a result of scarring, although some women report more erotic sensitivity at breast scar sites.
• Weight gain or loss. Weight changes from chemotherapy and other medicines may cause you to feel uncomfortable in clothing that no longer fits. You may have low energy, feel discouraged about losing or gaining weight and become self-critical about your body shape.
• Hair loss. Even short-term changes, such as losing head and body hair from chemotherapy, can have a major effect on how you feel about yourself. Losing pubic hair makes some women feel less sexual. Others enjoy this change. Your hair, on your head and elsewhere, will often grow back.
• Breast loss. Surgery may take a part of a breast, or can remove the entire breast. If one or both of your breasts are removed, you may choose to have your breast(s) rebuilt through reconstructive surgery.
  • Breast reconstruction may restore the shape and size of your lost breast. It can’t restore normal feeling in the breast. Your nipple(s) also might be removed.
  • Over time, the skin on the rebuilt breast becomes more sensitive, but usually you will not feel the same kind of pleasure as before surgery. Still, breast reconstruction may help restore sexual enjoyment because it can boost feelings of wholeness and attractiveness.
  • Instead of reconstruction, you might choose to use a prosthesis, a breast form inserted in a bra, or to wear nothing at all.
  • Lumpectomy, or partial removal of the breast, may leave the breast misshapen. Prosthetics or surgery may restore shape.

Improving body image

Getting comfortable with your new body takes time. These tips can help:

• Look at yourself in the mirror regularly. Try to be kind to yourself and accepting of your new body.
  • Think of how much your body has gone through and how strong it is.
• Shower and dress to feel good every day, even when you’re not in the mood.
• After breast cancer surgery, it’s common to feel self-conscious about being nude during sex. Camisoles, lingerie or nightgowns might make you feel sexy and boost your confidence.
  • Talk with your partner about what feels good sexually.
• If you’re not already physically active, talk with your healthcare provider and start a walking plan or other exercise you like. Physical activity can improve your body image and mood.
• Seek the advice of an oncology social worker or mental health professional experienced in treating women with cancer.
• Take part in a breast cancer support group.

Over time, these actions may help you adjust, release negative feelings about your body and embrace the future.