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Gréco Cinzia

PhD student in Anthropology of Health, EHESS

Postgraduate program: Health, Population and Social Policies, EHESS

SHS scholarship from Cancéropôle Ile-de-France

Contact: cinzia.greco(at)ehess.fr

Résumé

Dissertation title: Breast reconstruction in cancer treatment and plastic surgery: A compared sociological analysis

Under the supervision of Ilana Löwy

This research aims to study the experience of patients and doctors in the area of mastectomy and lumpectomy in the Île-de-France region. In particular, the research will focus on analyzing the mechanisms that influence the choice between lumpectomy, mastectomy, and breast reconstruction. The French situation will be compared with the Italian one in order to highlight similarities and differences (from a technical point of view, that of how the care system is organized, etc.) in the courses of treatment in the two contexts. The comparative approach will provide a better understanding of the role of the context in breast-cancer care. We will also compare plastic surgery with the practice of mastectomy and breast reconstruction. We shall try to understand the links and differences between these two typologies of surgical intervention carried out on the same body region, but with different goals and in different situations. We propose to study the respective doctor-patient relationships and their goals. Many mastectomies can be followed by a reconstruction operation, which adds to the oncological questions of complications specific to plastic surgery. Oncological surgery and plastic surgery share an obvious interest in the patient’s health and well-being, with the first focusing on the removal of tumor or tumor-risk tissue, and the second on the possibility of reconstruction and aesthetic results. Moreover, the same development of surgical techniques that preserve the skin or the nipple shows the joint presence of an oncological goal and an aesthetic one.

On their side, patients have an even broader range of interests – health, safety, aesthetic appearance, and mental and physical integrity – and they can have different motivations to choose breast reconstruction or not; these motivations can be of a medical nature, but they can also be related to goals or difficulties of a different nature.

The goal of this research is to investigate, through in-depth interviews with patients and the care staff, the unfolding of the course of treatment, the complex of information and doctor-patient relationships, and the conditions under which a decision was made to perform a reconstruction operation or not. We also propose to gain better knowledge of the expectations, hesitations, and doubts of women who have had a mastectomy. This study will also be able to help to understand the role of the “gender schemes” of the patients and professionals in reconstruction and plastic-surgery choices.

Keywords: Breast Cancer, Plastic Surgery, Gender, France, Italy

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