Women’s Regrets After Bilateral Prophylactic Mastectomy
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Background: Primary prevention strategies such as chemopreventive agents (e.g., tamoxifen) and bilateral prophylactic mastectomy (PM) have received increasingly more attention as management options for women at high risk of developing breast cancer.
Methods: A total of 370 women, who had registered in the Memorial Sloan-Kettering Cancer Center National Prophylactic Mastectomy Registry, reported having undergone a bilateral PM. Twenty-one of these women expressed regrets about their decision to have a PM. A psychiatrist and psychologist interviewed 19 of the women about their experiences with the PM.
Results: A physician-initiated rather than patient-initiated discussion about the PM represented the most common factor in these women. Psychological distress and the unavailability of psychological and rehabilitative support throughout the process were the most commonly reported regrets. Additional regrets about the PM related to cosmesis, perceived difficulty of detecting breast cancer in the remaining breast tissue, surgical complications, residual pain, lack of education about the procedure, concerns about consequent body image, and sexual dysfunction.
Conclusions: Although a PM statistically reduces the chances of a woman developing breast cancer, the possibility of significant physical and psychological sequelae remains. Careful evaluation, education, and support both before and after the procedure will potentially reduce the level of distress and dissatisfaction in these women. We discuss recommendations for the appropriate surgical and psychiatric evaluation of women who are considering a PM as risk-reducing surgery.
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- Women’s Regrets After Bilateral Prophylactic Mastectomy
Annals of Surgical Oncology
Volume 7, Issue 2 , pp 150-154
- Cover Date
- Print ISSN
- Online ISSN
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- Breast cancer
- Prophylactic mastectomy
- Psychological distress
- Genetic risk
- Industry Sectors
- Author Affiliations
- 1. Department of Psychiatry and Behavioral Sciences, Barbara White Fishman Center for Psychological Counseling, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 421, New York, NY, 10021
- 3. Department of Surgery, Division of Breast Oncology, Cook County Hospital, Chicago, IL
- 2. Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 421, New York, NY, 10021