Influence of Body Image on Intentions for Prophylactic Mastectomy

Abstract

Purpose: The purpose of this study was to determine if body image influences decision-making regarding prophylactic mastectomy (PM) in women at familial risk for breast and ovarian cancer. Method: 79 (Age X=48.1, SD=11.5; 99% Caucasian) women at high risk for breast and/or ovarian cancer who already underwent genetic counseling and/or testing for BRCA1/2 mutations were interviewed. Questionnaires measuring appearance evaluation and orientation, intrusive ideation, perceived risk of breast cancer, intentions for PM, pros and cons of PM were administered. Results: A small significant difference was found between affected and unaffected woman's intentions for PM, with more unaffected women considering undergoing a PM. We found a non-significant negative trend between appearance orientation with intentions for PM in unaffected women (x=0.281, p=0.09). Age was an independent predictor of PM in the whole sample (odds ratio (OR)=1.60; 95% confidence interval (CI), 1.17--2.20; p=0.003). Ratings of pros of PM was an independent predictor of intentions for PM in the whole sample and unaffected women (odds ratio (OR) 0.89; 95% confidence interval (CI), 0.802--0.981; p=0.02) and (odds ratio (OR)=1.60; 95% confidence interval (CI), 1.17--2.20; p=0.003), respectively. Conclusion: Numerous factors influence decision-making regarding PM in women at high risk for breast and ovarian cancer. Although body image did not significantly predict intentions for PM we found that it had some influence on intentions for PM in women without a previous diagnosis of breast cancer. Tailoring interventions that inform and prepare these high risk women for the specific physical and emotional changes of prophylactic mastectomy may be beneficial.