INTRODUCTION
primary breast cancer, anxiety
SURGICAL COMPLICATIONS, TREATMENT SIDE EFFECTS
While the use of unilateral mastectomies in the treatment of primary breast cancer (BC) has decreased, there has been steadily increasing use of bilateral mastectomy (BMX)BMX is an elective procedure for a unilateral BC, because it involves more surgery than is required for treatment. Given that BMX may have detrimental effects including surgical complications and associated costsEmotional responses are complex, coordinated phenomena that lead to behavioral, cognitive, and physiological changes, activate action tendencies, and modulate feelings.Thus, emotion dysregulation, involving anxiety, fear, and other negative emotions may be a major factor in decisions regarding BC faced by some 255,000 women in the United States every year. The desire to reduce understandable current anxiety by accepting major treatment side effects to avoid the future risk of regret may drive decisions that are inconsistent with actual risk reduction. We conducted a case–control study utilizing fMRI to better understand the influence of emotion regulation on the decision of newly diagnosed BC patients choosing BMX rather than unilateral mastectomies or breast‐conserving treatments (non‐BMX), with the ultimate goal of developing an intervention to enable the management of cancer‐related anxiety by nonsurgical means. The central hypotheses of the study are that: (1) BC patients choosing BMX rather than non‐BMX treatments would show more difficulty regulating the emotion elicited by unpleasant stimuli, in particular those relevant to BC, and, (2) BC patients would show greater emotional reactivity to stimuli with content relevant to BC than controls.