Psycho-Oncology Psycho-Oncology 19: 893–897 (2010) Published online 21 December 2009 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/pon.1675 Brief Report Psychosocial effects of mastectomy on married African women in Northwestern Nigeria V. I. Odigie 1 , Rika Tanaka 2Ã , L. M. D. Yusufu 1 , A. Gomna 1 , E. C. Odigie 3 , D. A. Dawotola 4 and Marko Margaritoni 5 1 Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria 2 Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA 3 Department of Nursing Services, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria 4 Radiotherapy and Oncology Centre, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria 5 Department of Surgery and Traumatology, Division of Plastic and Breast Surgery, General Hospital, Dubrovnik, Croatia Abstract Objectives: 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. Copyright r 2009 John Wiley & Sons, Ltd. Keywords: breast cancer; Nigeria; psychosocial; psycho-oncology; psychosexual functioning Psychosocial effects of mastectomy on married African women in Northwestern Nigeria At the Ahmadu Bello University Teaching Hospi- tal (ABUTH), in Zaria, Nigeria, breast cancer has become the most common cancer among all women irrespective of ethnic and socio-cultural differences. The majority of breast masses recorded in Northwest Nigeria are of a late presentation of a malignant tumor; the median survival is predicted to be 31 months [1–3]. In contrast to the many studies of psychosocial impact of breast cancer on women in the Western world, very few studies have examined the psychosocial impact of breast cancer and its treatment on African women in a developing country who largely have little educa- tion, live with few resources and have a strong dependency on their husbands. Studies examining the psychosocial impact of breast cancer in the West have highlighted concerns about the effect of breast cancer and its treatment on psychological health, physical/sexual function- ing, fertility, body image and social support [4–9]. The severity of psychosocial distress experienced by breast cancer survivors varies by age, pre-existing psychological conditions, comorbid physical con- ditions and social support. Nevertheless, it is important to note that the majority of the literature indicates that most women diagnosed with breast cancer remain well adjusted and highly functioning after primary treatment [10]. * Correspondence to: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY 10022, USA. E-mail: tanakar@mskcc.org Received: 3 November 2009 Accepted: 4 November 2009 Copyright r 2009 John Wiley & Sons, Ltd.