Torrisi Christa
Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO, United States.
Front Psychol. 2021 Dec 16;12:778484. doi: 10.3389/fpsyg.2021.778484. eCollection 2021.
The presence of a breast cancer (BRCA) gene mutation increases a woman's lifetime risk of developing breast cancer. Bilateral risk-reducing mastectomy is a proactive treatment option which lowers that risk. However, breast removal can create a change in physical appearance. It is unclear if BRCA-positive women undergoing this surgery in young adulthood, a life stage where intimate relationships, families, and careers are being established, have the same experience with body image as women in later stages of life. The aim of this literature review is to assess how bilateral risk-reducing mastectomy impacts body image in young BRCA-positive women less than 40 years of age, with no history of breast cancer. Database searches were performed, yielding 402 results. Studies were considered if participants had an increased lifetime breast cancer risk/BRCA-positive diagnosis and history of bilateral risk-reducing mastectomy, body image was evaluated, and mean age was less than 40 years. A total of three qualitative studies and three quantitative studies were identified as relevant for this review. A dearth of information exists on body image in young women following bilateral risk-reducing mastectomy. It was found in this review that some women experienced a decline in body image following surgery, while in others body image was maintained or improved. Understanding factors that impact body image following this risk-reducing surgery will allow clinicians to support this unique population. Open and informative discussion should be encouraged with young women considering, or who have undergone, bilateral risk-reducing mastectomy.
乳腺癌（BRCA）基因突变的存在会增加女性一生中患乳腺癌的风险。双侧预防性乳房切除术是一种降低该风险的积极治疗选择。然而，切除乳房会改变身体外观。目前尚不清楚在成年早期（这个生命阶段正在建立亲密关系、组建家庭和发展事业）接受这种手术的BRCA基因检测呈阳性的女性，在身体形象方面的体验是否与处于生命后期的女性相同。这篇文献综述的目的是评估双侧预防性乳房切除术对年龄小于40岁、无乳腺癌病史的BRCA基因检测呈阳性的年轻女性的身体形象有何影响。进行了数据库检索，得到402条结果。如果参与者有患乳腺癌的终身风险增加/BRCA基因检测呈阳性的诊断以及双侧预防性乳房切除术的病史、评估了身体形象且平均年龄小于40岁，则纳入相关研究。总共确定了三项定性研究和三项定量研究与本综述相关。关于双侧预防性乳房切除术后年轻女性的身体形象，现有信息匮乏。在本次综述中发现，一些女性术后身体形象下降，而另一些女性的身体形象则保持不变或有所改善。了解影响这种降低风险手术后身体形象的因素，将使临床医生能够为这一特殊人群提供支持。对于考虑或已经接受双侧预防性乳房切除术的年轻女性，应鼓励进行开放且信息丰富的讨论。
