Persentase orang yang kemudian menyesali setiap pilihan. Diagram batang dan catatan lengkap ditampilkan di bawah.
Kesehatan
Terakhir ditinjau 2026-07-14
Kualitas bukti 4.25/5
Skor tinjauan delapan dimensi terhadap
rubrik kualitas
. Setiap dimensi dinilai 1–5.
D1 Verifikasi sumber
5/5
D2 Otoritas & independensi sumber
5/5
D3 Akurasi tingkat penyesalan
3/5
D4 Keterbandingan sumber
3/5
D5 Pola Gilovich
4/5
D6 Kualitas prosa
5/5
D7 Kelengkapan peringatan
5/5
D8 Kualitas sampel
4/5
Rata-rata4.25/5
Data proksi — tidak ada survei penyesalan langsung untuk keputusan ini. Tingkat diturunkan dari skor kepuasan dan data hambatan akses daripada pertanyaan yang langsung menanyakan tentang penyesalan. Lihat peringatan di bawah.
19% tidak puas dengan prosedur rata-rata 14,5 tahun kemudian (Frost); dalam kohort terpisah 7% tidak akan memilih operasi itu lagi dan 33% mendapati hasil kosmetiknya tidak seperti yang diharapkan
Pembawa BRCA / perempuan berisiko tinggi setelah mastektomi profilaksis bilateral
rata-rata 14,5 tahun pascaprosedur
Penyesalan atas kelambanan
Memilih pemantauan intensif alih-alih operasi
14%
tidak ada survei penyesalan langsung — proksi: kekhawatiran kanker justru naik, bukan turun, di bawah pemantauan, dan 14% pemilih pemantauan mengembangkan kanker payudara (28/201 dalam median 5,9 tahun; kumulatif 9,9% pada 5 tahun)
Pembawa BRCA / perempuan berisiko tinggi yang memilih pemantauan payudara intensif
insidens kasar selama median 5,9 tahun tindak lanjut; kekhawatiran diukur selama 6-8 bulan
% menyesal dengan pilihan ini
Menjalani mastektomi pengurang risiko (profilaksis)Memilih pemantauan intensif alih-alih operasi
19%14%
balanced — Cukup seimbang — kedua pilihan membawa penyesalan serupa.
Keputusan terkait
Keputusan yang serupa secara semantik — area yang sama, kompromi yang berbeda.
At long follow-up, roughly one in five women is dissatisfied with a risk-reducing mastectomy. The largest long-term study — 572 women a mean of 14.5 years after bilateral prophylactic mastectomy at the Mayo Clinic — found 19% dissatisfied with the procedure, alongside 74% who reported diminished emotional concern about developing breast cancer (Frost et al., 2000). That dissatisfaction is mostly about the body rather than the decision: about a third reported an unfavourable effect on satisfaction with body appearance, and a quarter on feelings of femininity. An independent Norwegian cohort of BRCA1/2 carriers pins the narrower figure down — only about 7% would not choose the same operation again, though a third said the cosmetic result was not as expected, and lower satisfaction clustered among women who found the decision process difficult or felt unsupported by their clinicians (Hyldebrandt et al., 2025). The regret that exists tends to attach to reconstruction complications and to decisions that felt externally initiated, not to the cancer-risk reduction the surgery reliably delivers.
The surveillance side has no direct regret survey at all, so its rate is a proxy assembled from two things. First, the harm that materialises: in a Canadian cohort, 14% of women who chose surveillance developed breast cancer (9.9% cumulative at five years), against 6% among those awaiting surgery (Macadam et al., 2021). Second, the burden that persists: on the one measure taken comparably on both arms — cancer worry — surgery lowers it and surveillance does not. A prospective cohort found anxiety fell over six to eight months in women who chose mastectomy but rose in women who chose surveillance, ending higher in the surveillance group (Dick et al., 2022). Developing a cancer is not the same as regretting the choice, and many surveillance-detected cancers are caught early, so the 14% inaction figure is a materialised-harm-plus-worry stand-in, not a measured regret rate.
The two numbers land close together, but the closeness is fragile: it depends on which proxy anchors each side. They are not measuring the same thing — the action rate is long-term dissatisfaction with an irreversible operation, while the inaction rate is cancer incidence plus unresolved worry among women who kept their breasts. Swap the broad 19% dissatisfaction for the narrower 7% who would not choose the surgery again, and the balance tips toward surveillance; anchor the inaction side on the 9.9% five-year cumulative incidence instead of the 14% crude rate, and it tips the other way. On the worry axis alone the surveillance side carries more — the Gilovich-typical pattern in which the road not taken keeps generating unease — but risk-reducing mastectomy is permanent and exacts body-image and reconstruction costs that surveillance never imposes, which is what holds the action-side dissatisfaction up to meet it. None of the underlying data is a US survey of the surveillance arm, and no study asks surveillance-choosers directly whether they would decide differently, so the near-balance is a direction with wide error bars, not a settled equivalence.
Sumber: tindakan
Buku besar klaim
Setiap angka di bawah ini adalah apa yang dilaporkan masing-masing sumber, dengan kutipan kata demi kata yang kami andalkan dan bagaimana kami sampai pada angka kami. Klik tautan mana saja untuk memverifikasi langsung.
[1]JAMA (Frost et al. 2000, Mayo Clinic) — Long-term satisfaction and psychological and social function following bilateral prophylactic mastectomy
Telaah sejawat
Among 572 women (94% of survivors), mean 14.5 years after bilateral prophylactic mastectomy: 70% satisfied with the procedure, 11% neutral, 19% dissatisfied; 74% reported a diminished level of emotional concern about developing breast cancer; negative effects were reported on satisfaction with body appearance (36%) and on feelings of femininity (25%)
Kutipan
“"Most women (70%) were satisfied with the procedure; 11% were neutral; and 19% were dissatisfied. Among the psychological and social variables, the most striking finding was that 74% reported a diminished level of emotional concern about developing breast cancer. The majority of women reported no change/favorable effects in levels of emotional stability (68%/23%), level of stress (58%/28%), self-esteem (69%/13%), sexual relationships (73%/4%), and feelings of femininity (67%/8%). Forty-eight percent reported no change in their level of satisfaction with body appearance; 16% reported favorable effects. However, 9%, 14%, 18%, 23%, 25%, and 36% reported negative effects in these 6 variables, respectively."
”
Data sumber dari
2000-07-19
Diakses
2026-07-14
Perhitungan
The action-side anchor. Frost et al. is the largest long-term follow-up of prophylactic mastectomy (n=572, mean 14.5 years, US Mayo Clinic cohort) and the standard reference for durable outcomes. It measures satisfaction, not "regret" directly: 19% were dissatisfied with the procedure at long follow-up, which we take as the action-side proxy for a lingering negative decision outcome. This overlaps with — but is broader than — outright decision regret (see the Hyldebrandt cohort, where only ~7% would not choose the operation again). The 19% dissatisfied largely reflects body-image, femininity, and cosmetic outcomes rather than a wish to have skipped the surgery altogether.
[2]Familial Cancer (Hyldebrandt et al. 2025) — Experiences with risk-reducing mastectomy in Norwegian BRCA1/2 carriers without prior breast cancer
Telaah sejawat
Of 190 BRCA1/2 carriers who had undergone risk-reducing mastectomy: 78.9% (150/190) satisfied and would choose the same procedure again; 13 (6.8%) would not choose the same operation again; 63 women (33%) said the operative result was not as expected; satisfaction with healthcare-system support gave an OR of 5.5 for being satisfied with RRM (p<0.01), and finding the decision difficult lowered the odds (OR 0.2, p=0.02)
Kutipan
“"78.9% (150/190) were satisfied with their decision and would choose the same procedure again. [...] 13 (6.8%) [would not have chosen the same operation]. [...] 63 women (33%) expressed that the result was not as expected. [...] Feeling satisfied with support from the health care system gave an OR of 5.5 for being satisfied with having undergone RRM (p < 0.01). Those who found the decision difficult had lower odds of being satisfied (OR 0.2, p = 0.02)."
”
Data sumber dari
2025-01-01
Diakses
2026-07-14
Perhitungan
Independent corroboration from a Norwegian cancer-unaffected BRCA1/2 cohort (n=190 who had RRM, of 272 respondents). It supplies the cleaner decision-regret figure: 6.8% would not choose the operation again — a floor well below Frost's 19% dissatisfaction, because "dissatisfied with the result" and "would not do it again" are different constructs. The third of women whose result was "not as expected" tracks the same body-image/reconstruction dissatisfaction Frost measures. The finding that a difficult decision process and weak healthcare support predict lower satisfaction is the source for the prose claim that RRM regret concentrates around reconstruction outcomes and decisions that felt externally driven rather than chosen.
Sumber: tidak bertindak
Buku besar klaim
Setiap angka di bawah ini adalah apa yang dilaporkan masing-masing sumber, dengan kutipan kata demi kata yang kami andalkan dan bagaimana kami sampai pada angka kami. Klik tautan mana saja untuk memverifikasi langsung.
[1]Hereditary Cancer in Clinical Practice (Dick et al. 2022) — Psychological factors and the uptake of preventative measures in BRCA1/2 pathogenic variant carriers: results of a prospective cohort study
Telaah sejawat
Prospective cohort (n=98). Anxiety in the intensified-breast-surveillance (IBS) group rose over 6–8 months (mean ~6.2 → ~6.6), while anxiety in the risk-reducing-mastectomy group, elevated just after test-result disclosure (T1 ~8.2, up from ~7.6 at baseline), fell to ~5.7 over the same period; elevated post-disclosure anxiety predicted opting for RRM (OR 1.2, p<0.01)
Kutipan
“"Baseline anxiety levels in women opting for RRM were high but decreased over time, while they increased in women opting for intensified breast surveillance (IBS). [...] Elevated levels of anxiety after genetic test result disclosure (T1) were associated with the decision to undergo RRM (p < 0.01; OR = 1.2, 95% CI = 1.05–1.42)." [Reported group means: RRM T1 8.2 → T2 5.7; IBS T1 6.2 → T2 6.6, so at follow-up the surveillance group's mean anxiety (6.6) exceeded the mastectomy group's (5.7).]
”
Data sumber dari
2022-12-01
Diakses
2026-07-14
Perhitungan
The construct-matched half of the inaction proxy, and the reason the two sides can be compared at all. On the one axis measured comparably on both arms — psychological burden / cancer worry — surgery lowers it and surveillance does not: the surveillance group's anxiety rose and ended higher than the mastectomy group's. This is the residual worry that is the honest analogue of "regret" for the surveillance choice. It is not a regret rate and yields no percentage; it fixes the direction of the worry burden, not the magnitude.
[2]Current Oncology (Macadam et al. 2021) — Prophylactic Surgery in the BRCA+ Patient: Do Women Develop Breast Cancer While Waiting?
Telaah sejawat
Of 333 BRCA carriers, 201 chose surveillance and 132 chose prophylactic mastectomy with immediate reconstruction. 28/201 surveillance patients (13.9%) developed invasive breast cancer vs 8/132 (6.1%) in the surgery group; 5-year cumulative incidence 9.9% (surveillance) vs 4.9% (surgery). 89% of surveillance-detected tumours were <20 mm
Kutipan
“"During this period, 6% of patients developed breast cancer compared with a 14% incidence of breast cancer in patients choosing surveillance. [...] At five years, the cumulative incidence of breast cancer in the surveillance group was 9.9% compared with 4.9% in the PM/IBR group." [Results: "201 patients chose S, 132 chose PM/IBR"; "Twenty-eight of the 201 surveillance patients and eight of 132 patients in the PM/IBR group developed invasive breast cancer"; median surveillance follow-up 5.9 yr; 89% of tumours <20 mm.]
”
Data sumber dari
2021-02-01
Diakses
2026-07-14
Perhitungan
The materialized-harm anchor for the inaction proxy. The inaction-side rate is set at 0.14 — the crude cited figure: 28 of 201 surveillance-choosers (13.9%) developed invasive breast cancer in this Canadian cohort over a median 5.9 years. No worry adjustment is applied; an earlier draft nudged this to 0.15 to "fold in" the rising cancer worry, but that increment has no source basis (Dick 2022 yields no regret percentage) and has been removed. The 5-year cumulative incidence of 9.9% is the alternative anchor; choosing it instead would move the rate to ~0.10 and the delta to ~0.09. Developing cancer is not itself "regret" — 89% of the surveillance-detected tumours were under 20 mm, i.e. screen-caught early, and no survey asks surveillance-choosers whether they regret the decision — so this is a materialized-harm-plus-worry proxy, not a regret survey. It is the closest available inaction anchor and is deliberately flagged as a proxy. Boundary call: with action 0.19 and inaction 0.14 the delta is exactly 0.05, sitting right on the rubric's balanced/action_dominates line (|delta| < 0.05 is balanced). The label is deliberately kept at "balanced" rather than tipped to "action_dominates" because the two rates are non-comparable proxies (long-term dissatisfaction vs materialized cancer incidence); a signed delta at the boundary between them carries no interpretable direction, so "neither side clearly dominates" is the honest reading.
Catatan
Kedua tingkat adalah proksi dari kohort yang tidak sebanding, dan entri ini dipublikasikan dengan pengungkapan proksi justru karena itu. Angka 19% di sisi tindakan adalah angka kepuasan/ketidakpuasan yang diukur rata-rata 14,5 tahun setelah mastektomi profilaksis bilateral (Frost 2000, AS, n=572); angka penyesalan-keputusan yang lebih bersih dari kohort BRCA independen jauh lebih rendah — sekitar 7% tidak akan memilih operasi itu lagi (Hyldebrandt 2025, Norwegia, n=190), dengan sepertiga melaporkan hasil kosmetik tidak seperti yang diharapkan. Angka 14% di sisi tanpa-tindakan sama sekali bukan tingkat penyesalan: ia dijangkarkan pada 14% pemilih pemantauan yang mengembangkan kanker payudara (Macadam 2021, Kanada, n=201; 28/201 dalam median 5,9 tahun, kumulatif 9,9% pada 5 tahun), sebuah kerugian yang terwujud, dengan lintasan kekhawatiran kanker yang meningkat di bawah pemantauan (Dick 2022, Eropa, n=98) sebagai korroborasi yang sepadan konstruknya. Tidak ada survei terpublikasi yang bertanya langsung kepada perempuan yang memilih pemantauan apakah mereka menyesalinya, sehingga tingkat tanpa-tindakan membawa ketidakpastian lebar. Kedua sisi mengukur konstruk yang berbeda — ketidakpuasan jangka panjang atas operasi yang tak dapat dibatalkan versus insidens kanker plus kekhawatiran sisa — sehingga delta 0,05 berada di batas keseimbangan dan bukan besaran yang dapat ditafsirkan ke arah mana pun; ia harus dibaca sebagai "tidak ada sisi yang jelas mendominasi", bukan sebagai kesetaraan persis dan bukan berarti tindakan lebih disesali. Keseimbangan-hampir itu juga sebagian artefak pemilihan jangkar: mengambil angka penyesalan-keputusan yang lebih bersih untuk sisi tindakan (7% Hyldebrandt yang tidak akan memilih lagi, alih-alih 19% ketidakpuasan Frost) akan membalik tanda ke arah tanpa-tindakan, sementara mengambil insidens kumulatif lima tahun 9,9% untuk sisi tanpa-tindakan akan melebarkan selisih menjadi sekitar 0,09. Keseimbangan itu karenanya adalah sifat dari proksi yang dipilih, bukan temuan. Satu sumbu yang diukur sebanding pada kedua lengan — beban psikologis — condong ke sisi pemantauan: kekhawatiran turun setelah operasi dan naik di bawah pemantauan, pola tanpa-tindakan khas Gilovich. Sebagai penyeimbang, mastektomi profilaksis tidak dapat dibatalkan dan membawa biaya citra tubuh, feminitas, dan komplikasi rekonstruksi yang tidak dibebankan pemantauan — itulah yang menjaga ketidakpuasan sisi tindakan cukup tinggi untuk mengimbanginya. Populasinya AS, Norwegia, Kanada, dan Eropa; tidak ada data penyesalan/kepuasan yang merupakan survei lengan pemantauan di AS. Penyesalan setelah mastektomi pengurang risiko terkonsentrasi di sekitar komplikasi rekonstruksi, harapan kosmetik yang tak terpenuhi, dan keputusan yang terasa diprakarsai pihak luar alih-alih dipilih sendiri (Hyldebrandt 2025) — bukan di sekitar pengurangan risiko kanker itu sendiri, yang secara andal diberikan operasi.
