Authors Name: 
Dawn Smyth
Waterford Institute of Technology
Nursing & Midwifery
Award winner

Abortion: Exploring the Ethical, Legal and Political Challenges

Background: Women with a genetic predisposition to breast cancer carry upwards of 80% lifetime risk of developing it. Consequently many women are now seeking to identify their genetic status and opting for prophylactic mastectomy based on the findings. Prophylactic mastectomy remains a controversial choice and though the risk reducing potential of prophylactic surgery remains indisputable, when considering such an irreversible course of action the physical and psychosocial consequences should be given due consideration. Objective: To employ an evidence based approach towards exploring the physical and psychological consequences of undergoing prophylactic mastectomy in women with a genetic risk of breast cancer and to determine the subsequent effect on quality of life. Findings: Few women regretted their decision to undergo prophylactic mastectomy and benefited from reduced cancer worry. However the physical and psychological costs of the procedure were significant. Postoperative complications, additional corrective surgeries, altered body image, chronic pain/discomfort, altered sexual functioning, relationship difficulties and depression were among the difficulties experienced. Conclusion/ Implications: In the aftermath of prophylactic mastectomy both the physical and psychological effects can have a significant impact on the individual’s quality of life. Evidence supports the need for pre-surgical counselling or a standard psychological consultation to inform the decision making process. Women considering the procedure should receive objective information and understand all options available to them. Patient expectations should be managed in line with the likely outcome and the possibility of experiencing complications should be well understood.