If a doctor recommends surgery, it will probably be covered by insurance; if she doesn’t, you may have to pay out of pocket, and if you have both mastectomy and reconstruction, the cost will be substantial—upwards of $20,000. Moreover, even when surgeons perform the nipple-sparing version of the procedure, the reconstructed breasts will look natural but will still lack sensation. “That can be a blow to both your body image and your sexuality,” says Susan Love, MD, founder of the Dr. -Susan Love Research Foundation and author of Dr. Susan Love’s Breast Book. When researchers at the Mayo Clinic followed up with breast-cancer survivors who had chosen to have a double mastectomy, a quarter of the women said the surgery had had a negative impact on their sexual relationships and their feelings of femininity.
Still, a number of studies show that most women who have preventive mastectomies are happy with their choice. “They may feel reassured by the fact that they’ve been aggressive about trying to fend off a recurrence,” says Tuttle. Then again, those who opt for lumpectomy and radiation say they’re satisfied, too. “The key factor seems to be feeling as if you made an informed decision,” Litton says. “That matters more than which option you chose.”
Ginny Graves’s last article for More was “The Pills We Can’t Kick.”
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