[Why do women refuse reconstructive breast surgery after mastectomy?]

The implementation of mammographic screening and neo-adjuvant therapeutics has profoundly modified breast cancer surgery, making it less aggressive. Despite these progresses, mastectomies must be performed in more than 20% of breast cancer cases. Psychological disorders following mastectomy are numerous and lead to various alterations of self-esteem, femininity and sexuality. Reconstructive breast surgery proves to be beneficial to improve these psychological disorders in about 20% of women, who accept breast mourning and appropriate their reconstructed breast. However, 80% of the patients refuse reconstructive breast surgery. Our review aims at analysing different motivations explaining reconstructive breast surgery refusal and different ways of "reconstructing psychologically" after mastectomy.