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Surgery can reduce anxiety in women at high risk of breast cancer


The psychosocial impact of bilateral prophylactic mastectomy: prospective study sing questionnaires and semistructured interviews

For women at high genetic risk of breast cancer, mastectomy can reduce anxiety and worry and does not have a detrimental impact on women's body image or sexual activity, finds a study in this week's BMJ.

Hatcher and colleagues offered surgery to 154 women at increased risk of developing breast cancer. Seventy-nine women accepted, 64 declined, and 11 deferred making a decision. Their psychological symptoms were subsequently assessed using interviews and questionnaires. They found that women choosing surgery had significantly reduced anxiety after surgery. Women who declined surgery had no such reduction in psychological symptoms. Furthermore, women who had surgery (most of whom had immediate reconstruction) maintained a positive body image and reported few or no changes in sexual activity, add the authors.

Women who choose such surgery have a higher, often inaccurate, perception of their risk of developing breast cancer, add the authors. Genetic counsellors need to ensure that women's decisions to have surgery are based on accurate perceptions, they conclude.



Lesley Fallowfield, Professor of Psycho-oncology, Royal Free and University College Medical School, London, UK Email:

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