Risk reducing mastectomy
Some women have a higher than normal risk of developing breast cancer. This is because they have had breast cancer before or inherited a particular gene (e.g. BRCA-1 or BRCA-2) and there is a history of breast cancer in the family. Usually, when a high risk of developing breast cancer is identified, the option of a risk reducing mastectomy may be considered. Although this does not remove all risk of breast cancer, it reduces the risk significantly.
Mastectomy for symmetrisation
Sometimes people have undergone a mastectomy due to cancer treatment but are left ‘lop-sided’ with unequal breasts. For some people, they would prefer to have no breasts at all than unequal breasts and so request a mastectomy for symmetrisation.
The decision, for both types of surgery, is a serious one because it is a big operation that cannot be reversed and like all surgery has its own risks. There are additional considerations, such as whether to have a breast reconstruction or whether to wear prostheses.
Why do I need to see a Clinical Psychologist?
Seeing a clinical psychologist to make a decision about surgery is a normal part of helping you prepare for this procedure.
It is important that you get the opportunity to explore your choices, thoughts and feelings with someone independent from the hospital team and your family.
Clinical psychologists are trained in helping people gain more understanding of themselves, in support and decision making, and in helping people look at things from different viewpoints.
A clinical psychologist will not judge or challenge your decision.
A clinical psychologist can also help you think about how to prepare for surgery and recovery, and the support that you may need, and about decisions about reconstruction.
What happens once I have been referred to a Clinical Psychologist?
An appointment with a clinical psychologist will usually last around an hour. Within this time you have the opportunity to talk about your experience: how your risk of breast cancer was identified, and the impact you feel it has on you. You can talk about your decisions around having (or not having) a mastectomy.
Do I need to have made a decision prior to the appointment?
You do not need to have made a decision prior to appointment, nor have to make a decision during the appointment. This appointment aims to help you think about which decision is best for you, but there is no time pressure. You can think about it as long as you need and ask for more sessions with a clinical psychologist if you feel that you need this.
What happens next?
The clinical psychologist will write a report about what has been discussed in your appointment and send this to you and to your surgical team.
During your appointment there will be an opportunity to jointly decide what information may be useful to be included in this report.
Following this, discussions between yourself and your surgical team usually take place to consider the next steps.
Are the sessions confidential?
The service maintains confidentiality within reasonable limits. We maintain records under the strict guidelines of the Data Protection Act 2018. Everyone has the right to request written information about themselves. Staff have a responsibility to pass on information on the health and safety of yourself or others if anyone is at significant risk of harm.
How do I find out more?
For more details please contact Dr Nita Baker, Consultant Clinical Psychologist, 01543 576609