Imagine not being able to fully feel a hug from your loved ones.
Not being able to feel your baby’s head nuzzled against your chest.
Feeling like a part of your body doesn’t belong to you.
These side effects are common following a mastectomy—and often permanent. Chest numbness is the result of nerves being cut during a mastectomy. When the severed nerves are not reconnected, they cannot transmit a signal to the brain, which can result in total or partial chest numbness.
The lack of sensation often leads breast cancer survivors to feel disconnected from themselves and others, making them wonder, “Am I ever going to feel whole again?”
As a clinical psychologist, I’ve worked with patients who have been deeply impacted by chest numbness. Not only does it pose a general safety risk (imagine not being able to sense if you’re getting burned by a curling iron or getting sunburned)—it can have a significant impact on one’s quality of life as well. I’ve heard some of my patients describe the experience as feeling like their chest had been “deleted.”
Psychologically, the chest holds deep connections to one’s self-identity and relationships with others. When you can’t feel someone’s embrace, it may foster feelings of disconnection. This can be intensely unsettling and impact one’s ability to feel intimacy or solidarity with others, which can be especially difficult following the emotional toll of a breast cancer diagnosis and treatment. What’s more, chest numbness can serve as a constant reminder of the trauma and a continued source of grief from what cancer has taken from a person.
My clients who have experienced chest numbness felt that they were either largely unaware or inadequately prepared by their care team for the impact it would have on their lives. Not being mentally prepared can be a significant challenge for people who are navigating life in their new bodies with this devastating side effect, all while coping, processing, and working through the trauma of cancer.
By sharing what I’ve learned in my own clinical practice, I hope fellow psychologists and other clinicians will be more prepared to provide the counsel and support their patients need—especially during the early days of a cancer diagnosis. I want people to know that chest numbness doesn’t have to be permanent, and there are potential solutions available.
Dr. Craig Larsen, a breast surgical oncologist at New York Breast Health, makes it a priority to talk with his patients about chest numbness. “When you hear the C word, you get blindsided. People just want the cancer out. They say they don’t care what it looks like, and they say they don’t care about sensation. However, once they wake up from surgery and the cancer is removed, what wasn’t important when faced with mortality suddenly becomes important. That’s why I am so explicit about expectations with my patients. I tell them, ‘I know you say you don’t care right now, but as your surgeon, I care, and I want the best outcome for you,'” says Dr. Larsen.
Being educated on the likelihood and quality-of-life effects of post-mastectomy numbness can empower patients to potentially mitigate this side effect—and, at the very least, to understand and emotionally process its impact on life after breast cancer (working with a therapist can help greatly).
Dr. Larsen also works closely with plastic surgeons who offer breast neurotization surgery—a nerve repair procedure that reconnects the nerves that are cut during a mastectomy using a nerve graft, potentially restoring sensation over time. Because nerves grow slowly, at a rate of about one millimeter per day, restoring sensation is not immediate; it can take months to regain sensation following surgery.
“Patients are usually happy just to have the cancer out. But I think we can do better than that. There are simple things we can do for our patients to feel more whole, safer, and more comfortable in their own skin,” says Dr. Larsen.
I can tell you from firsthand clinical experience that the psychological impact of chest numbness is significant and can impact self-identity, happiness, and wellness. That’s why I encourage you to follow Dr. Larsen’s lead in proactively preparing your patients for sensation loss after mastectomy. Knowledge is the power our patients deserve to not only preserve life but also quality of life. Make sure they are aware of the option to receive breast neurotization as part of their reconstruction. They will thank you for it.
Kristen Casey is a clinical psychologist.
