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    Mastectomy to Prevent Cancer Reduces Women's Worries

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    Hoffman agrees, telling WebMD, "They may have an idealized picture in their minds of what the breast will look like, which is not always possible, so they are unhappy with the results."

    In Frost's study, the small number of women who did not elect to have breast reconstructive surgery showed greater satisfaction with their decision. Frost speculates that these women place less emphasis on their breasts as part of their self-image. In her study, those who decided against breast reconstruction had fewer negative feelings about their femininity and body appearance. Further, those women "would not have been exposed to concerns about implants and other problems with reconstructive surgery," Frost says.

    Despite the high satisfaction rate reported by Frost, most women at high risk of breast cancer do not choose prophylactic mastectomy. "However, there's a great deal of interest in this fairly extreme option, so we have needed insights into the long-term sense of satisfaction with this choice," Robert A. Smith, PhD, director of cancer screening at the American Cancer Society, tells WebMD.

    "This is not a decision to be made quickly. It's not a decision to be made without all the facts, and not without considerable degree of expert counseling, about what this may offer you. What's your underlying risk of breast cancer and death from breast cancer?

    "Ultimately, many of these women would not have developed breast cancer," Smith tells WebMD. "The point to keep in mind is we are not able to truly predict who will get breast cancer and who will not."

    Before making such a big decision, women should talk to a therapist, Nadine Kaslow, PhD, professor of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta, tells WebMD. "Obviously this is an incredible psychological and medical decision, and all factors have to be weighed."

    When considering reconstructive surgery, she advises women to get a clear idea of what they can expect. "Ask for pictures. Get an idea of what this surgeon does. You want to be realistic about this. I also encourage women to get pictures of the breasts immediately post-op, so they can see what it looks. Swelling goes down tremendously after the first few days."

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