Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2017 Jan 7

PMID 28058563

Citations 21

Authors

Chelsea Anderson

Jessica Y Islam

M Elizabeth Hodgson

Susan A Sabatino

Juan L Rodriguez

Clara N Lee

Dale P Sandler

Hazel B Nichols

Affiliations

Soon will be listed here.

Abstract

Background: Contralateral prophylactic mastectomy (CPM) rates have been increasing in the US, and although high levels of satisfaction with CPM have been reported, few studies have evaluated the long-term effects on body image, comparing CPM with breast-conserving surgery (BCS) and unilateral mastectomy (UM).

Methods: We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n = 1176). Among women who underwent mastectomy, we examined satisfaction with the mastectomy decision, as well as variation in the use of reconstruction and experience of complications. Five survey items, evaluated individually and as a summed total score, were used to compare body image across surgery types (BCS, UM without reconstruction, CPM without reconstruction, UM with reconstruction, and CPM with reconstruction).

Results: Participants were, on average, 3.6 years post-diagnosis at the time of survey (standard deviation 1.7). The majority of women (97% of CPM, 89% of UM) were satisfied with their mastectomy decision. Reconstruction was more common after CPM than after UM (70 vs. 47%), as were complications (28 vs. 19%). Body image scores were significantly worse among women who underwent CPM than among women who underwent BCS, with the lowest scores among women who underwent CPM without reconstruction.

Conclusions: In our sample, most women were highly satisfied with their mastectomy decision, including those who elected to undergo CPM. However, body image was lower among those who underwent CPM than among those who underwent BCS. Our findings may inform decisions among women considering various courses of surgical treatment.

Citing Articles

"Peace of Mind" After Mastectomy: A Scoping Review.

Hamid S, Bakkila B, Schultz K, Grimshaw A, Gunderson C, Godfrey E Ann Surg Oncol. 2024; 31(8):5168-5179.

PMID: 38717543 DOI: 10.1245/s10434-024-15360-3.

Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks.

Singh P, Agnese D, Amin M, Barrio A, van den Bruele A, Burke E Ann Surg Oncol. 2024; 31(4):2212-2223.

PMID: 38261126 DOI: 10.1245/s10434-024-14893-x.

Contralateral Prophylactic Mastectomy Decision-Making: The Partners' Perspective.

Nash A, Bloom D, Chapman B, Wheeler S, McGuire K, Lee C Ann Surg Oncol. 2023; 30(10):6268-6274.

PMID: 37573282 DOI: 10.1245/s10434-023-14022-0.

Preserving choice in breast cancer treatment: A different perspective on contralateral prophylactic mastectomy.

Pender K, Dodge D, Collins J Womens Health (Lond). 2023; 19:17455057231175812.

PMID: 37218720 PMC: 10214065. DOI: 10.1177/17455057231175812.

EBCC-13 manifesto: Balancing pros and cons for contralateral prophylactic mastectomy.

Schmidt M, Kelly J, Bredart A, Cameron D, de Boniface J, Easton D Eur J Cancer. 2023; 181:79-91.

PMID: 36641897 PMC: 10326619. DOI: 10.1016/j.ejca.2022.11.036.

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