Mastectomy in a large public hospital.

Thirty women undergoing mastectomy for carcinoma of the breast in a large teaching hospital were interviewed. All indicated a very real need to discuss their experiences, and felt that the interview had been beneficial to them. Most had found the "lump" themselves--but often described it as a "hardness", a "ridge", or a "thickening". More than half felt that the counselling afforded to them had been inadequate--especially in the realm of sexual adjustment--but, if their marriages had been stable before operation, subsequent deterioration was unlikely. The threat of malignancy, rather than that of breast loss, was uppermost in the minds of most patients. It should not be assumed that postmastectomy problems do not exist because patients do not mention them, especially in large busy follow-up clinics, where privacy may be inadequate. If doctors are unable or unwilling to afford this service to their mastectomy patients, it may be necessary to delegate it to other health professionals and mastectomy volunteers.