Psychological Implications of Mastectomies in Women with Increased Risk of Breast Cancer

Women's Cancer Research Foundation

Jan 173 min read

The decision to undergo a risk-reducing mastectomy is a profound one for women facing a high risk of breast cancer. While the procedure significantly decreases the likelihood of developing cancer, it is not without its immediate psychological impacts. Recent research delves into the emotional and mental health challenges that women encounter immediately before and after this preventative surgery. Understanding these effects is crucial for providing comprehensive care and support to those making this life-altering decision.

Recent research delves into the emotional and mental health challenges that women encounter immediately before and after mastectomy.

Risk-reducing mastectomy (surgery to remove the breast) is recommended for high-risk breast cancer patients but the surgery may have significant psychological consequences. In a recent study, researchers sought to determine the differences in anxiety, depressive symptomatology, body image and quality of life in women with an increased risk of breast cancer immediately before and after undergoing risk-reducing mastectomy. Eighty-eight women with an increased risk of breast cancer due to a BRCA1/2 mutation (a genetic mutation that is associated with a predisposition to develop breast or ovarian cancer) or a previous cancer diagnosis participated in this study.

Patients underwent the Hospital Anxiety and Depression Scale, Body Image Scale and the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire at 15-30 days before and after surgery. Following surgery, there was an immediate and significant worsening in anxiety, depressive symptomatology and body image. There was a significant deterioration in global, physical, and social functioning, as well as in body image and sexual enjoyment. Additionally, there were increases in fatigue, nausea and vomiting, constipation, dyspnea (difficult or labored breathing), insomnia, appetite loss, perceived financial difficulties, pain, systemic therapy side effects, and breast and arm symptoms. Risk-reducing mastectomies have immediate psychological consequences.

The findings of this recent study highlight the psychological consequences of such surgical procedures, emphasizing the need for comprehensive psychological interventions for patients both before and after surgery.

While these procedures improve health outcomes, they increase anxiety and depressive symptomatology and decrease body image and quality of life, regardless of cancer diagnosis or BRCA1/2 mutation. Ultimately, these findings highlight the psychological consequences of such surgical procedures, emphasizing the need for comprehensive psychological interventions for patients both before and after surgery.

The study underscores the complex trade-offs involved in undergoing risk-reducing mastectomies. While these surgeries are effective in mitigating the physical threat of cancer, the emotional and psychological toll they exact cannot be overlooked. These findings accentuate the importance of integrating psychological support into the treatment and recovery process for women undergoing these procedures. Health systems and cancer support networks must ensure that holistic care, encompassing mental health support, is a fundamental component of the pre and post-surgery journey. By doing so, we can help these courageous women navigate not only the physical challenges but also the mental and emotional hurdles they face.

About Women’s Cancer Research Foundation:

The Women’s Cancer Research Foundation (WCRF) is one of the most active research organizations in the nation. We are dedicated to studying and evaluating novel treatments for women afflicted with breast, ovarian, endometrial, and cervical cancers. The WCRF persistently endeavors to make a difference in women’s lives by offering them hope, strength, and progress.