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"You have breast cancer" may be some of the most devastating words a woman may hear. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women behind lung cancer in the United States (). According to ACS, more than 180,000 U.S. women will be diagnosed with breast cancer in 2008 and more than 40,000 will die from this disease. Although the incidence of breast cancer has increased, death rates are on the decline due to early detection and improved treatments ().

Breast cancer is the most common cancer diagnosis for North American and Western European women. Increased knowledge in availability of genetic testing has helped to identify those women at high risk of eventually developing breast cancer. This has resulted in more women considering bilateral prophylactic mastectomy as a viable preventative option. Although the efficacy of the procedure has been established, much less is known about the psychological impact of undergoing this procedure. In order to assess these factors, we reviewed what is currently known about the psychological impact of undergoing bilateral prophylactic mastectomy. Searches were conducted and inclusion criteria revealed articles that focused on the psychological components involved with undergoing a bilateral prophylactic mastectomy. The findings are summarized and fell broadly into one or more of the following three areas: (1) satisfaction or regret following the surgery, (2) psychosocial functioning after the surgery, and (3) predictors of quality of life. Plastic surgery nurses have a unique opportunity to impact important psychological considerations, such as expectations of the early postoperative period, body image concerns, and psychological distress.

Women diagnosed with breast cancer have many physiological and psychological adjustments to make following mastectomy. The present study described in this article sought to determine the decision-making patterns used by two groups of women. Nurses need to be well informed and professionally confident to provide the individualized care and support deserved by women throughout the breast cancer trajectory. A major outcome of such professional care is confident women who understand their disease, treatments, and methods to manage stresses as they occur.

Microsurgical tissue transplantation initiated a new dimension in breast reconstruction and is the preferred method for carefully selected patients. The inferior gluteus maximus musculocutaneous flap provides abundant tissue for a permanently soft and well-contoured breast with a donor site that is often enhanced by tissue sculpting. As a knowledgeable and skilled member of a multi-disciplinary team, the professional nurse is in a position strategic to the success of breast reconstruction utilizing microsurgical tissue transfer.

With the advent of tissue expansion, breast reconstruction is being performed routinely on an ambulatory surgery basis. Nurses in the ambulatory setting may not realize the great need that this patient has for emotional support.