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Long-Term Patient-Reported Satisfaction after Contralateral Prophylactic Mastectomy and Implant Reconstruction

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To determine whether satisfaction and health-related quality of life (HR-QoL) differ between women who do and do not undergo contralateral prophylactic mastectomy (CPM) in the setting of implant reconstruction using the BREAST-Q, a validated patient-reported outcome instrument.

Methods

From 2000 to 2007, a total of 3,874 patients with stage 0 to III unilateral breast cancer (BC) had mastectomy; 688 (18 %) pursued CPM within 1 year. Patients who completed the BREAST-Q reconstruction module as part of BREAST-Q validation studies or routine clinical care formed our study cohort. Comparisons were made between CPM and no-CPM patients using univariate analysis and multivariate models (MVA).

Results

Of 294 patients with BREAST-Q data, 112 (38 %) had CPM. Median time from mastectomy to BREAST-Q was 52 months. CPM patients were younger (mean 47 vs. 50 years), more likely to be White (98 vs. 86 %), married (84 vs. 71 %), have a family history of BC (60 vs. 44 %), and to choose silicone implants (67 vs. 48 %). There were no differences in tumor or treatment characteristics between groups at the time of BREAST-Q. Patients with CPM had a higher mean score for Satisfaction with Breasts (64.4 vs. 54.9; p < 0.001) and Satisfaction with Outcome (74.8 vs. 67.7; p = 0.007); other HR-QoL domains did not differ. On MVA, CPM and the absence of lymphedema were significant predictors of Satisfaction with Breasts (CPM p = 0.005, lymphedema p = 0.039). CPM was not associated with improved Satisfaction with Outcome.

Conclusions

This study suggests that in the setting of implant reconstruction, CPM has a positive correlation with patient satisfaction with their breasts, but not with improvements in other HR-QoL domains.

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Acknowledgment

This study was supported by the Cary Grossman Breast Research Fund. The BREAST-Q is available to clinicians and researchers at www.BREAST-Q.org.

Disclosure

The BREAST-Q is owned by Memorial Sloan-Kettering Cancer Center and the University of British Columbia. Dr. Pusic is a codeveloper of the BREAST-Q and receives a share of licensing revenues based on the inventor sharing policies of these two institutions. The other authors declare no conflict of interest.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Starr Koslow MD, Lindsay A. Pharmer MD, Michelle Stempel MPH, Monica Morrow MD & Tari A. King MD

  2. Plastic and Reconstructive Surgical Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Amie M. Scott MPH & Andrea L. Pusic MD MHS

Authors
  1. Starr Koslow MD
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  2. Lindsay A. Pharmer MD
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  3. Amie M. Scott MPH
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  4. Michelle Stempel MPH
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  5. Monica Morrow MD
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  6. Andrea L. Pusic MD MHS
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  7. Tari A. King MD
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Correspondence to Tari A. King MD.

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Koslow, S., Pharmer, L.A., Scott, A.M. et al. Long-Term Patient-Reported Satisfaction after Contralateral Prophylactic Mastectomy and Implant Reconstruction. Ann Surg Oncol 20, 3422–3429 (2013). https://doi.org/10.1245/s10434-013-3026-2

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  • DOI: https://doi.org/10.1245/s10434-013-3026-2

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