Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original Article

Vol. 4 No. 3 (2025): September 2025

Understanding sexuality and social support among post-mastectomy breast cancer patients: A qualitative study in Indonesia

DOI
https://doi.org/10.55048/jpns176
Published
2025-09-30

Abstract

Background: Breast cancer is the most prevalent cancer among women worldwide. Mastectomy, a standard treatment, often leads to profound physical and psychological changes that can affect women's sexuality and their need for social support.

Objective: This study explored how post-mastectomy breast cancer patients in Indonesia perceive their sexuality and the social support they receive during recovery.

Methods: A qualitative phenomenological design was employed. Fifteen women who had undergone mastectomy were recruited through purposive sampling. Data were collected using semi-structured interviews and analyzed using Van Manen's phenomenological approach, with NVivo 12 Plus used for data management.

Results: Six major themes emerged: (1) sex and gender perceptions remained stable despite physical changes; (2) sexual identity and femininity were preserved; (3) participants consistently identified as heterosexual, in line with their premorbid orientation; (4) intimacy was shaped by partner support and body acceptance; (5) reproductive limitations were acknowledged, particularly among older women; and (6) social support from family, peers, and healthcare providers was critical for emotional adjustment and sexual well-being.

Conclusion: Despite altered body image, most participants maintained a strong sense of femininity and sexual identity. Emotional, instrumental, and informational support from spouses, children, communities, and healthcare professionals facilitated positive adaptation. Integrating sexuality-focused counseling and involving families in post-mastectomy care are recommended to promote holistic recovery.

References

  1. American Cancer Society. (2019a). Cancer facts and figures 2019. Cancer Facts and Figures 2019. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf
  2. American Cancer Society. (2019b). Cancer treatment & survivorship facts & figures 2019-2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf
  3. Anand, U., Dey, A., Chandel, A. K. S., Sanyal, R., Mishra, A., Pandey, D. K., De Falco, V., Upadhyay, A., Kandimalla, R., Chaudhary, A., Dhanjal, J. K., Dewanjee, S., Vallamkondu, J., & Pérez de la Lastra, J. M. (2023). Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes and Diseases, 10(4), 1367–1401. https://doi.org/10.1016/j.gendis.2022.02.007 DOI: https://doi.org/10.1016/j.gendis.2022.02.007
  4. Antle, B., & Collins, W. (2009). The impact of a spirituality-based support group on self-efficacy and well-being of African American breast cancer survivors. Social Work & Christianity, 36, 286–300.
  5. Archangelo, S. de C. V., Sabino, M., Veiga, D. F., Garcia, E. B., & Ferreira, L. M. (2019). Sexuality, depression and body image after breast reconstruction. Clinics, 74, 1–5. https://doi.org/10.6061/clinics/2019/e883 DOI: https://doi.org/10.6061/clinics/2019/e883
  6. Cardoso, F., Kyriakides, S., S, O., Penault-Llorca, F., Poortmans, P., Rubio, I., Zackrisson, S., & Senkus, E. (2019). Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 374, 1–77. https://doi.org/10.1093/annonc/mdz173 DOI: https://doi.org/10.1093/annonc/mdz189
  7. Carr, T. L., & Cochran, D. (2019). Exploring women' s support needs after breast reconstruction surgery. 42(2), 1–9. https://doi.org/10.1097/NCC.0000000000000600 DOI: https://doi.org/10.1097/NCC.0000000000000600
  8. Chow, W. L., Su-Ming Tan, Aung, K. C. Y., Chua, S. Y. N., & Sim, H. C. (2019). Factors influencing quality of life of Asian breast cancer patients and their caregivers at diagnosis: perceived medical and psychosocial needs. Singapore Medical Journal, 1(21), 1–21. https://doi.org/10.11622/smedj.2019099 DOI: https://doi.org/10.11622/smedj.2019099
  9. Chuang, L.-Y., Hsu, Y.-Y., Yin, S.-Y., & Shu, B.-C. (2018). Staring at my body. Cancer Nursing, 41(3), E56–E61. https://doi.org/10.1097/ncc.0000000000000507 DOI: https://doi.org/10.1097/NCC.0000000000000507
  10. Daem, M., Verbrugghe, M., Schrauwen, W., Leroux, S., Van Hecke, A., & Grypdonck, M. (2019). How Interdisciplinary Teamwork Contributes to Psychosocial Cancer Support. Cancer Nursing, 42(3), E11–E20. https://doi.org/10.1097/NCC.0000000000000588 DOI: https://doi.org/10.1097/NCC.0000000000000588
  11. Denewer, A., Farouk, O., & Mostafa, W. (2011). Social support and hope among Egyptian women with breast cancer after mastectomy. Breast Cancer: Basic and Clinical Research, 5, 93–103. DOI: https://doi.org/10.4137/BCBCR.S6655
  12. Drageset, S., Lindstrøm, T. C., Giske, T., & Underlid, K. (2012). "The support i need": Women's experiences of social support after having received breast cancer diagnosis and awaiting surgery. Cancer Nursing, 35(6), 39–47. https://doi.org/10.1097/NCC.0b013e31823634aa DOI: https://doi.org/10.1097/NCC.0b013e31823634aa
  13. Dsouza, S. M., Vyas, N., Narayanan, P., Parsekar, S. S., Gore, M., & Sharan, K. (2018). A qualitative study on experiences and needs of breast cancer survivors in Karnataka, India. Clinical Epidemiology and Global Health, 6(2), 69–74. https://doi.org/10.1016/j.cegh.2017.08.001 DOI: https://doi.org/10.1016/j.cegh.2017.08.001
  14. Finsex. (2007). The origin of sexuality and sexual knowledge. 11–28. https://www.vaestoliitto.fi/@Bin/263341/Finsex09_Chapter+1.pdf DOI: https://doi.org/10.1007/BF02853934
  15. Fouladi, N., Pourfarzi, F., Dolattorkpour, N., Alimohammadi, S., & Mehrara, E. (2018). Sexual life after mastectomy in breast cancer survivors: A qualitative study. Psycho-Oncology, 27(2), 434–441. https://doi.org/10.1002/pon.4479 DOI: https://doi.org/10.1002/pon.4479
  16. Ghizzani, A., Bruni, S., & Luisi, S. (2018). The sex life of women surviving breast cancer. Gynecological Endocrinology, 34(10), 821–825. https://doi.org/10.1080/09513590.2018.1467401 DOI: https://doi.org/10.1080/09513590.2018.1467401
  17. International Agency for Research on Cancer (IARC). (2019). Indonesia GLOBOCAN 2018. The Global Cancer Observatory, 256, 1–2.
  18. Jakobsen, K., Magnus, E., Lundgren, S., & Reidunsdatter, R. J. (2018). Everyday life in breast cancer survivors experiencing challenges: A qualitative study. Scandinavian Journal of Occupational Therapy, 25(4), 298–307. https://doi.org/10.1080/11038128.2017.1335777 DOI: https://doi.org/10.1080/11038128.2017.1335777
  19. Janowski, K. (2019). Social support and psychosocial functioning in women after mastectomy. DOI: https://doi.org/10.1017/S1478951519000774
  20. Kollberg, K. M. S. (2014). Psychosocial support needs after a breast cancer diagnosis.
  21. Kowalczyk, R., Nowosielski, K., Cedrych, I., Krzystanek, M., Glogowska, I., Streb, J., Kucharz, J., & Lew-Starowicz, Z. (2018). Factors affecting sexual function and body image of early stage breast cancer survivors in Poland: A short-term observation. Clinical Breast Cancer. https://doi.org/10.1016/j.clbc.2018.09.006 DOI: https://doi.org/10.1016/j.clbc.2018.09.006
  22. Kurniawan, D., Manurung, I., & Rohayati, R. (2019). Hubungan mekanisme koping dengan proses berkabung pada pasien pre operasi kanker. Jurnal Ilmiah Keperawatan Sai Betik, 14(2), 176. https://doi.org/10.26630/jkep.v14i2.1303 DOI: https://doi.org/10.26630/jkep.v14i2.1303
  23. Lundberg, P. C., & Phoosuwan, N. (2022). Life situations of Swedish women after mastectomy due to breast cancer: A qualitative study. European Journal of Oncology Nursing, 57(August 2021), 102116. https://doi.org/10.1016/j.ejon.2022.102116 DOI: https://doi.org/10.1016/j.ejon.2022.102116
  24. Maharjan, M., Thapa, N., Adhikari, R. D., Petrini, M. A., Amatya, K. S., M., M., N., T., R.D., A., & M.A., P. (2018). Quality of life of nepalese women post mastectomy. Asian Pacific Journal of Cancer Prevention?: APJCP, 19(4), 1005–1012. https://doi.org/10.22034/APJCP.2018.19.4.1005
  25. National Breast Cancer Coalition. (2022). Breast cancer facts & figures. https://www.stopbreastcancer.org/information-center/facts-figures/#:~:text=In 2020 there were 684%2C996,will die of breast cancer.
  26. Observatory, G. C. (2022). Absolute numbers, Incidence, Both sexes 2022.
  27. Olasehinde, O., Arije, O., Wuraola, F. O., Samson, M., Olajide, O., Alabi, T., Arowolo, O., Boutin-Foster, Carla Alatise Olusegun, I., & Kingham, T. P. (2019). Life without a breast: Exploring the experiences of young nigerian women after mastectomy for breast cancer. Journal of Global Oncology, 5, 1–6. https://doi.org/10.1200/jgo.18.00248 DOI: https://doi.org/10.1200/JGO.18.00248
  28. Pa?ari?, S., Kristek, J., Mirat, J., Kondža, G., Turk, T., Far?i?, N., Orki?, Ž., & Nem?i?, A. (2018). The quality of life of Croatian women after mastectomy: A cross-sectional single-center study. BMC Public Health, 18(1), 1–8. https://doi.org/10.1186/s12889-018-5929-0 DOI: https://doi.org/10.1186/s12889-018-5929-0
  29. Pambudi, H. A., Dwidiyanti, M., & Wijayanti, D. Y. (2018). Pandangan lansia tentang seksualitas pada lanjut usia. Jurnal Kesehatan, 9(1), 154–159. https://doi.org/10.26630/jk.v9i1.819 DOI: https://doi.org/10.26630/jk.v9i1.819
  30. Puspita, R. T., Huda, N., & Safri. (2017). Hubungan dukungan sosial dengan citra tubuh pasien kanker payudara post op mastektomi. Jurnal Ners Indonesia, 8(1).
  31. Rojas, K., Onstad, M., Raker, C., Clark, M., Stuckey, A., & Gass, J. (2017). The impact of mastectomy type on the Female Sexual Function Index (FSFI), satisfaction with appearance, and the reconstructed breast's role in intimacy. Breast Cancer Research and Treatment, 163(2), 273–279. https://doi.org/10.1007/s10549-017-4174-z DOI: https://doi.org/10.1007/s10549-017-4174-z
  32. Rosenfeld, B., Cham, H., Pessin, H., & Breitbart, W. (2018). Why is Meaning-Centered Group Psychotherapy (MCGP) effective? Enhanced sense of meaning as the mechanism of change for advanced cancer patients. Psycho-Oncology, 27(2), 654–660. https://doi.org/10.1002/pon.4578 DOI: https://doi.org/10.1002/pon.4578
  33. Sowa, M., G?owacka-Mrotek, I., Monastyrska, E., Nowikiewicz, T., Mackiewicz-Milewska, M., Hagner, W., & Zegarski, W. (2018). Assessment of quality of life in women five years after breast cancer surgery , members of Breast Cancer Self-Help Groups – non- randomized , cross-sectional study. Contemporary Oncology, 22(1), 20–26. https://doi.org/https://doi.org/10.5114/wo.2018.74389 DOI: https://doi.org/10.5114/wo.2018.74389
  34. Stoker, G., & Clarke, P. J. (2018). Mastectomy information for patients. Oxford University Hospital: NHS Trust, 301(7803), 617. https://doi.org/10.1016/S0140-6736(73)90774-5 DOI: https://doi.org/10.1016/S0140-6736(73)90774-5
  35. Sun, L., Ang, E., Ang, W. H. D., & Lopez, V. (2018). Losing the breast: A meta-synthesis of the impact in women breast cancer survivors. Psycho-Oncology, 27(2), 376–385. https://doi.org/10.1002/pon.4460 DOI: https://doi.org/10.1002/pon.4460
  36. Tasripiyah, A. ., Prawesti, A., & Rahayu, U. (2012). Hubungan koping dan dukungan sosial dengan body image pasien kanker payudara post mastektomi di poli bedah onkologi RSHS Bandung. Jurnal Universitas Padjajaran, 1–15.
  37. Tristiana, R. D., Kusnanto, Widyawati, I. Y., Yusuf, A., & Fitryasari, R. (2014). Kesejahteraan psikologis pada pasien diabetes mellitus tipe 2 di Puskesmas Mulyorejo Surabaya. April.
  38. Tristiana, R. D., Kusnanto, Widyawati, I. Y., Yusuf, A., & Fitryasari, R. (2016). Psychological well being in type 2 diabetes mellitus patients in mulyorejo public health center, Surabaya. Jurnal NERS, 11(2), 147. https://doi.org/10.20473/jn.v11i22016.147-156 DOI: https://doi.org/10.20473/jn.V11I22016.147-156
  39. Witdiawati, Purnama, D., & Eriyani, T. (2017). Sosial budaya dalam kehidupan klien kanker payudara: Literature study. Jurnal Keperawatan BSI, V(2), 148–154.
  40. World Health Organization. (2023). Breast Cancer.
  41. Wulandari, S. M., Yunitasari, E., & Kusumaningrum, T. (2020). Managing cancer and living meaningfully for advanced cancer: a systematic review. Jurnal Ners, 15(1S), 1. https://dx.doi.org/10.20473/jn.v15i2.18894 DOI: https://doi.org/10.20473/jn.v15i1Sp.18894
  42. Wulandari, S. M., Yunitasari, E., Kusumaningrum, T., Myint, N. M. M., & Subu, M. A. (2023). Body image perception among breast cancer patients after mastectomy: A phenomenology study. The Journal of Palembang Nursing Studies. https://doi.org/http://dx.doi.org/10.55048/jpns87 DOI: https://doi.org/10.55048/jpns87

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Most read articles by the same author(s)