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Annals of Surgical Oncology

, Volume 22, Issue 2, pp 401–408 | Cite as

Impact of Reconstruction and Reoperation on Long-Term Patient-Reported Satisfaction After Contralateral Prophylactic Mastectomy

  • Judy C. Boughey
  • Tanya L. Hoskin
  • Lynn C. Hartmann
  • Joanne L. Johnson
  • Steven R. Jacobson
  • Amy C. Degnim
  • Marlene H. Frost
Breast Oncology

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.

Keywords

Breast Reconstruction Contralateral Prophylactic Mastectomy Lower Satisfaction Silicone Implant Reconstruction Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

There are no financial disclosures or potential conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Judy C. Boughey
    • 1
  • Tanya L. Hoskin
    • 2
  • Lynn C. Hartmann
    • 3
  • Joanne L. Johnson
    • 4
  • Steven R. Jacobson
    • 5
  • Amy C. Degnim
    • 1
  • Marlene H. Frost
    • 4
  1. 1.Division of Subspecialty General Surgery, Department of SurgeryMayo Clinic College of Medicine, Mayo Clinic Cancer CenterRochesterUSA
  2. 2.Department of Health Sciences ResearchMayo Clinic College of MedicineRochesterUSA
  3. 3.Department of Medical OncologyMayo Clinic College of Medicine, Mayo Clinic Cancer CenterRochesterUSA
  4. 4.Cancer CenterMayo Clinic Cancer CenterRochesterUSA
  5. 5.Division of Plastic and Reconstructive Surgery, Department of SurgeryMayo Clinic College of Medicine, Mayo Clinic Cancer CenterRochesterUSA

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