Skip to main content

Research Repository

Advanced Search

The psychological effect of mastectomy with or without breast reconstruction: a prospective, multi-centred study

Harcourt, Diana; Rumsey, Nichola; Ambler, Nicholas R.; Cawthorn, Simon J.; Reid, Clive D.; Madox, Paul R.; Kenealy, John M.; Rainsbury, Richard M.; Umpleby, Harry C.


Diana Harcourt
Professor in Appearance Research

Nicholas R. Ambler

Simon J. Cawthorn

Clive D. Reid

Paul R. Madox

John M. Kenealy

Richard M. Rainsbury

Harry C. Umpleby


A multicenter, prospective study (n = 103) examined the psychological implications of women's decisions for or against breast reconstruction. Recognized measures of anxiety, depression, body image, and quality of life were completed before the operation, and 6 and 12 months later. A reduction in psychological distress over the year following the operation was evident in each surgical group (mastectomy alone or immediate or delayed reconstruction), indicating that reconstructive surgery can offer psychological benefits to some women; however, others report improved psychological functioning without this surgical procedure. In contrast to existing retrospective research, the prospective design enabled the process of adjustment during the first year after the operation to be examined. The results indicate that breast reconstruction is not a universal panacea for the emotional and psychological consequences of mastectomy. Women still reported feeling conscious of altered body image 1 year postoperatively, regardless of whether or not they had elected breast reconstruction. Health professionals should be careful of assuming that breast reconstruction necessarily confers psychological benefits compared with mastectomy alone.


Harcourt, D., Rumsey, N., Ambler, N. R., Cawthorn, S. J., Reid, C. D., Madox, P. R., …Umpleby, H. C. (2003). The psychological effect of mastectomy with or without breast reconstruction: a prospective, multi-centred study. Plastic and Reconstructive Surgery, 111(3), 1060-1068

Journal Article Type Article
Publication Date Mar 1, 2003
Journal Plastic and Reconstructive Surgery
Print ISSN 0032-1052
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 111
Issue 3
Pages 1060-1068
Keywords psychological effect, mastectomy, breast reconstruction, visible difference, body image
Public URL
Publisher URL
Additional Information Additional Information : This led to an invitation to join the DH Cancer Reform Strategy Breast Cancer Working Group and a working party developing guidelines for the provision of oncoplastic breast surgery, published as Baildam et al (2007). Oncoplastic Breast Surgery: a guide to good practice, European Journal of Surgical Oncology, 33, S1-S23.