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    Mastectomy to Prevent Cancer Reduces Women's Worries


    There has been "intense speculation" about the psychological ramifications of such surgery, says Frost, who found that 70% of the women surveyed were satisfied with the procedure, 11% were neutral, and 19% were dissatisfied.

    "The most striking finding was that 74% reported less emotional concern about developing breast cancer," Frost writes. "The majority reported favorable effects or no change in self-esteem, satisfaction with body appearance, feelings of femininity, sexual relationships, level of stress in life, and overall emotional stability."

    But among those who felt negatively about their decision, 18% suffered from lower self-esteem, 25% indicated the surgery adversely affected their sexual relationships, and 36% felt less feminine.

    Of the seven women who eventually developed breast cancer after having both breasts removed, six were still alive. "None of the women voiced dissatisfaction and five of the six said they 'definitely' or 'probably' would choose prophylactic mastectomy again," Frost says. Their reasons: "it was the best decision at the time ... they were comfortable with their body image, it provided peace of mind, and ... it provided risk reduction or enhanced detection of cancer." One woman, though, reported that the procedure gave her a false sense of security.

    Satisfaction with breast reconstructive surgery was quite another issue. While 95% of the women surveyed chose reconstructive surgery, only 69% reported being either satisfied or very satisfied with the results.

    For some women, the results of breast reconstruction are "not exactly what they expected," Alison Estabrook, MD, chief of breast surgery at St. Luke's-Roosevelt-Hospital Center's Comprehensive Breast Center in New York, tells WebMD.

    "They are very happy that they have a decrease in breast cancer risk, ...If you ask them about medical health, they're probably happy they did what they did," says Estabrook. "But it changes their lives, and our experience is that a lot of women are pretty shocked about what they did. They did it for good reasons, but a lot have emotional trauma to go through, with readjustments to their bodies. And they're young, a lot of them are dancers, doing things that involve their bodies a lot. If you're looking at their psychosocial adjustment, it's a problem."

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