Women's regrets after bilateral prophylactic mastectomy Journal Article


Authors: Payne, D. K.; Biggs, C.; Tran, K. N.; Borgen, P. I.; Massie, M. J.
Article Title: Women's regrets after bilateral prophylactic mastectomy
Abstract: 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.
Keywords: adult; aged; middle aged; patient satisfaction; major clinical study; cancer prevention; breast cancer; mastectomy; breast neoplasms; distress syndrome; genetic risk; patient attitude; breast surgery; body image; stress, psychological; psychological distress; adjustment; prophylactic mastectomy; humans; human; female; article
Journal Title: Annals of Surgical Oncology
Volume: 7
Issue: 2
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2000-03-01
Start Page: 150
End Page: 154
Language: English
PUBMED: 10761795
PROVIDER: scopus
DOI: 10.1007/s10434-000-0150-6
DOI/URL:
Notes: Export Date: 18 November 2015 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. David K Payne
    19 Payne
  2. Patrick I Borgen
    253 Borgen
  3. Mary Jane Massie
    80 Massie
  4. Katherine N Tran
    15 Tran