The psychological consequences of mastectomy can be substantial, as women face the distress and disfigurement caused by the loss of a breast in addition to the fear of a life-threatening disease. We have previously measured psychosocial functioning after mastectomy in women with and without breast reconstruction. We measured changes in psychosocial functioning from before surgery and at one year after surgery in three distinct groups: 1) women with mastectomy alone; 2) women with mastectomy plus immediate reconstruction; and 3) women with mastectomy plus delayed reconstruction. We are now in a position to measure changes in psychosocial functioning at 5 years after initial surgery. We will compare characteristics of women who had undergone reconstruction in the 5-year time period as opposed to those who did not. The objectives of this study are to: 1) assess the uptake of breast reconstruction 5 years following mastectomy 2) to assess changes in psychosocial functioning (quality of life, body image, cancer-related distress, decisional conflict, psychological distress, coping style, and sexual functioning) in women five years following surgery (mastectomy alone and mastectomy plus delayed reconstruction) 3) To assess predictors of uptake of uptake of delayed breast reconstruction between two groups of women (women who had mastectomy alone or women with mastectomy plus delayed reconstruction.