DISCUSSION
The women who ultimately received BMX showed less activation in prefrontal brain regions that are associated with emotion regulation than those who received non‐BMX surgeries. Particularly, the non‐BMX group showed greater activation than the BMX group in the dmPFC and dlPFC during the application of reappraisal to regulate negative emotions elicited by BC‐related pictures.Consistent with our hypothesis, the self‐reported BC‐IAPS differential reactivity was significantly higher in BC patients than controls. It suggests that with IAPS pictures as a baseline, BC patients reported stronger relative emotional reactivity to BC‐related pictures than their healthy counterparts. The fMRI data further corroborated this finding. When comparing the neural differential BC‐IAPS reactivity, BC patients showed significantly stronger activation in regions within the default mode network (DMN), including vmPFC, PCC, and precuneus. These brain regions are typically involved in self‐reflection and self‐evaluation processes.It is interesting that the BC patient‐control group difference in neural reactivity did not appear in core limbic regions such as the amygdala, but was consistently evident in several DMN regions. The amygdala typically reflects low‐level aspects of emotional reactivity. The DMN, on the contrary, is typically involved in self‐referential cognitive processes.It is of clinical importance that greater activations of dmPFC and dlPFC during emotion regulation differentiate the non‐BMX and BMX groups. These components of the Executive Control Network (ECN) are crucial to emotion regulation, so their hypoactivation during the presentation of distressing visual stimuli, for cancer‐related images in particular, is consistent with a reduced ability to modulate negative emotion.