Why Does a Mastectomy Present a Particularly Difficult Problem in Terms

Why does a mastectomy present a particularly difficult problem in terms of female sexual readjustment?

A) The loss of a breast will interfere with adequate lactation for a new baby.
B) The resulting decline in estrogen will impair sexual functioning and pleasure.
C) The female breast symbolizes sexuality in our culture,so she may feel less sexual.
D) The medication tamoxifen stops the production of all sex hormones,thus libido and responsiveness are totally lost.