But it is that kind of talk — suggesting that a reconstructed breast is an improvement on a woman’s natural breast — that enrages many women who have undergone mastectomies. For starters, a reconstructed breast is often numb and can no longer play a role in sexual arousal. It often lacks a nipple, since the nipple is usually removed in a mastectomy.

After looking at photos of reconstructed breasts, “I was slightly horrified,” said Charlie Scheel, 48, of Brooklyn, who decided against implants after a double mastectomy. “You don’t have nipples and you have scars everywhere.”

Rebecca Pine, a cancer survivor from Long Island who co-founded a photography and writing project called “The Breast and the Sea,” said, “It’s a tremendous amount to put your body through, and it’s not like we’re going to get our breasts back.”

Ms. Pine, 40, had reconstruction after her first mastectomy, but had the implant removed later when she had a prophylactic mastectomy on her other breast. “They don’t look or feel, in most cases, like our breasts,” she said. “The nerves are cut, so they’re not receptive to feel or touch.”

Dr. Susan Love, author of a best-selling book about breast health, said that doctors aiming to expand access to reconstruction may have become overly enthusiastic about the surgery.

“Surgeons became so proud of what we were able to do that we may have forgotten that not everybody may want it,” Dr. Love said.

Dr. Marisa C. Weiss, founder of breastcancer.org, said doctors should not assume every patient wants reconstructed breasts. “I’ve had go-go dancers who do not want reconstruction and nuns who say, ‘I need reconstruction,’” she said.