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. 2015 Feb;22(2):401-8.
doi: 10.1245/s10434-014-4053-3. Epub 2014 Sep 6.

Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy

Judy C Boughey  1 , Tanya L Hoskin, Lynn C Hartmann, Joanne L Johnson, Steven R Jacobson, Amy C Degnim, Marlene H Frost
Affiliations

Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy

Judy C Boughey et al. Ann Surg Oncol. 2015 Feb.

Abstract

Background: Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.

Methods: 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960 and 1993 were surveyed regarding quality of life (QOL) and satisfaction with CPM at two time points (approximately 10 and 20 years after CPM).

Results: 583 women responded to the first follow-up questionnaire (median 10.7 years; mean 11.9 years) after CPM. There were 403 (69 %) patients who underwent reconstruction and 180 (31 %) patients who did not. Women electing reconstruction were younger [mean age 47 versus (vs.) 53 years; p = 0.01] and more likely to be married (85 vs. 78 %; p = 0.048). Most women reported satisfaction with CPM (83 %), and they would choose CPM again (84 %) and make the same choice regarding reconstruction (73 %). However, reconstruction patients demonstrated significantly lower satisfaction (p = 0.0001) and were less likely to choose CPM again (p < 0.0001). Within the reconstruction group, 39 % needed 1 + unplanned reoperation, which was strongly associated with lower satisfaction (p = 0.0001), lower likelihood of choosing CPM again (p = 0.006), and lower likelihood of choosing reconstruction again (p < 0.0001). There were 269 women who responded to the second questionnaire (median 18.4 years; mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92 % of the women stating they would choose CPM again.

Conclusions: Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.

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Conflict of interest statement

Disclaimer: There are no financial disclosures or potential conflicts of interest

Figures

Figure 1
Figure 1
Figures 1a and 1b. Questionnaire responses regarding patient satisfaction with CPM (Fig 1a) and whether they would choose to have CPM again (Fig 1b) comparing those with and without reconstruction
Figure 2
Figure 2
Figures 2a–2c. Questionnaire responses regarding patient satisfaction with CPM (Fig 2a), whether they would choose to have CPM again (Fig 2b) and whether they would choose reconstruction again (Fig 2c) comparing those with and without any reoperation
See this image and copyright information in PMC

References

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