A couples-based team approach to prophylactic bilateral mastectomy and social disapproval

Prophylactic bilateral mastectomy (PBM) is the current recommended course of action for women with increased genetic risk for breast and ovarian cancer. Nevertheless, many receive negative feedback from family and friends surrounding the decision to undergo this surgery because they do not have cancer when the decision is made; this results in a limited support network for coping with their PBM. Low social support is associated with depression, negativity, and anxiety. Women who had a PBM, were currently undergoing or had completed reconstruction, and were in a committed romantic relationship at the time of the surgery were surveyed (N = 53). The hypotheses that women who received negative feedback about their decision to have a PBM would have poorer individual well-being, and that the use of a couples-based team approach would moderate these adverse effects were tested. Data analyses support the hypotheses that women in couples taking a team approach to PBM have better individual well-being. The effects of negative feedback from others about the decision to undergo a PBM on personal mental health were moderated by use of a couples-based team approach. Women who received negative feedback from multiple sources had better outcomes if they used a couples-based team approach. Many women have a preventative oophorectomy around the same time as their PBM. Menopause is associated with side effects such as increased vasomotor symptoms and decreased sexual functioning. The hypothesis that surgical menopause is related to declines in sexual satisfaction following PBM was also tested. Regression analysis revealed no relationship. This study indicates that women who experience social disapproval and lack collaborative support from their significant other may be at increased risk for poor individual well-being following PBM.