title: Psychosocial effects of mastectomy on married African women in Northwestern Nigeria.
abstract: OBJECTIVE
  Few studies have examined the psychosocial impact of breast cancer and its treatment on African women who come from a poverty-stricken, uneducated background in a developing country. The purpose of this study was to describe the specific psychosocial effects of breast cancer on married African women in order to help physicians educate and counsel future women and their families in Northwestern Nigeria.
  
  
  METHODS
  Two semi-structured, self-report questionnaires were given to 81 consenting married African women treated with unilateral total mastectomy secondary to operable breast cancer at the Ahmadu Bello University Teaching Hospital. Questionnaires were answered at the time of the diagnosis and treatment consultation and at 6 months postmastectomy and included questions about demographics, frequency of conjugal relations and how the woman's sense of femininity was affected. Marital status was also tracked up to 3 years.
  
  
  RESULTS
  Six months after surgery, the survey responses revealed that 67.9% of women felt inadequate as a woman because of the mastectomy and that 79.0% experienced a decrease in frequency of conjugal relations. Three years after primary breast cancer treatment, 61.7% of the participants were still married while 38.3% reported being divorced/separated from their husbands.
  
  
  CONCLUSIONS
  These results indicated that married African women face significant physical, emotional and social changes and difficulties following primary breast cancer treatment. Culturally sensitive therapeutic groups and interventions should be established to help Nigerian women with breast cancer and their spouses and families understand and cope with the disease and its long-term health and quality-of-life implications.
authors.affiliation: Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
authors.forename: V I
authors.initials: VI
authors.lastname: Odigie
authors.forename: Rika
authors.initials: R
authors.lastname: Tanaka
authors.forename: L M D
authors.initials: LM
authors.lastname: Yusufu
authors.forename: A
authors.initials: A
authors.lastname: Gomna
authors.forename: E C
authors.initials: EC
authors.lastname: Odigie
authors.forename: D A
authors.initials: DA
authors.lastname: Dawotola
authors.forename: Marko
authors.initials: M
authors.lastname: Margaritoni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000523:psychology*; D001828:Body Image; D001943:Breast Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D003906:Developing Countries; D004243:Divorce / Q000523:psychology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D006785:Hospitals, University; D006801:Humans; D017533:Marital Status; D015413:Mastectomy, Simple / Q000523:psychology*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000523:psychology; D009549:Nigeria; D011203:Poverty / Q000523:psychology; D011610:Psychosocial Deprivation; D012725:Sexual Behavior; D012944:Social Support; D012945:Social Values; D011795:Surveys and Questionnaires; D055815:Young Adult