Angelina Jolie’s recent announcement that she had a prophylactic double mastectomy to reduce her risk of developing breast cancer has cast a very public spotlight on what is often a very private issue.

In addition to the surgery’s physical effects, there can be an array of emotional and psychological impacts and implications. “A high risk woman who is considering surgery must also balance her fears, her emotional, physical, and sexual investment in her breasts, her life circumstance, her resources, her family’s concerns, and her screening alternatives to decide how best to manage her cancer risks,” explains Andrea Farkas Patenaude, PhD, a psychologist in the Cancer Genetics and Prevention Clinic at Dana-Farber Cancer Institute in Boston and author of “Prophylactic Mastectomy: Insights from Women who Chose to Reduce their Risk” (Praeger Books, 2012).

Patenaude’s book shares insight from 21 women who had a prophylactic mastectomy, including what they thought were the high and low points as they considered the merits of the surgery, and a checklist of questions women might want to use when considering whether a prophylactic double mastectomy is the right decision for them. The number of women electing to have a prophylactic double mastectomy is increasing, but most high-risk women still do not elect to have the surgery.

Patenaude says women struggle with this decision because it is both very personal and there is no clear best or right choice. However, now that prophylactic double mastectomy is being discussed more publicly, Patenaude is hopeful that more women will have greater access to information and clinical resources to help them make a decision that is right for them.

Dana-Farber Cancer Institute ( is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center, designated a comprehensive cancer center by the National Cancer Institute. It provides adult cancer care with Brigham and Women’s Hospital as Dana-Farber/Brigham and Women’s Cancer Center and it provides pediatric care with Boston Children’s Hospital as Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. Dana-Farber is the top ranked cancer center in New England, according to U.S. News & World Report, and one of the largest recipients among independent hospitals of National Cancer Institute and National Institutes of Health grant funding. Follow Dana-Farber on Facebook: and on Twitter: @danafarber.