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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2011

01-10-2011 | American Society of Breast Surgeons

Contralateral Prophylactic Mastectomy: Long-Term Consistency of Satisfaction and Adverse Effects and the Significance of Informed Decision-Making, Quality of Life, and Personality Traits

Authors: Marlene H. Frost, PhD, Tanya L. Hoskin, MS, Lynn C. Hartmann, MD, Amy C. Degnim, MD, Joanne L. Johnson, RN, Judy C. Boughey, MD

Published in: Annals of Surgical Oncology | Issue 11/2011

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Abstract

Purpose

This study aims to evaluate the long-term consistency of satisfaction with contralateral prophylactic mastectomy (CPM) and adverse psychosocial effects as well as to explore the effect of informed decision-making, personality traits, and quality of life (QOL) on satisfaction.

Methods

A previously established cohort of women with unilateral breast cancer who had undergone CPM between 1960 and 1993 were surveyed using study-specific and standardized questionnaires at two follow-up time points. The first survey was a mean of 10.7 years and the second survey a mean of 20.2 years after CPM.

Results

487 of the 583 women who responded to the first study were alive and resurveyed. Data from both surveys were available for 269 women. With longer follow-up, there was a small increase in the percentage of women satisfied (90%) and those who would choose CPM again (92%) (4% and 2% increase from first survey, respectively). Most adversely affected were body appearance (31%), feelings of femininity (24%), and sexual relationships (23%). Ninety-three percent of women felt they had made an informed decision. Perception of making an informed choice and current QOL were moderately associated with satisfaction with CPM (r = 0.37 and 0.37, respectively) while associations with trait anxiety and optimism were weak (r = 0.27 and 0.21, respectively).

Conclusions

Long-term satisfaction and adverse effects remained remarkably stable. It is important that women fully understand the benefits and adverse effects associated with CPM.
Literature
1.
Boughey JC, Hoskin TL, Degnim AC, et al. Contralateral prophylactic mastectomy is associated with a survival advantage in high-risk women with a personal history of breast cancer. Ann Surg Oncol. 2010;17:2702–9.PubMedCrossRef
2.
Herrinton LJ, Barlow WE, Yu O, et al. Efficacy of prophylactic mastectomy in women with unilateral breast cancer: a cancer research network project. J Clin Oncol. 2005;23:4275–86.PubMedCrossRef
3.
McDonnell SK, Schaid DJ, Myers JL, et al. Efficacy of contralateral prophylactic mastectomy in women with a personal and family history of breast cancer. J Clin Oncol. 2001;19:3938–43.PubMed
4.
Peralta EA, Ellenhorn JD, Wagman LD, Dagis A, Andersen JS, Chu DZ. Contralateral prophylactic mastectomy improves the outcome of selected patients undergoing mastectomy for breast cancer. Am J Surg. 2000;180:439–45.PubMedCrossRef
5.
van Sprundel TC, Schmidt MK, Rookus MA, et al. Risk reduction of contralateral breast cancer and survival after contralateral prophylactic mastectomy in BRCA1 or BRCA2 mutation carriers. Br J Cancer. 2005;93:287–92.PubMedCrossRef
6.
Tuttle TM, Abbott A, Arrington A, Rueth N. The increasing use of prophylactic mastectomy in the prevention of breast cancer. Curr Oncol Rep. 2010;12:16–21.PubMedCrossRef
7.
Tuttle TM, Habermann EB, Grund EH, Morris TJ, Virnig BA. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25:5203–9.PubMedCrossRef
8.
Tuttle TM, Jarosek S, Habermann EB, et al. Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. J Clin Oncol. 2009;27:1362–7.PubMedCrossRef
9.
Altschuler A, Nekhlyudov L, Rolnick SJ, et al. Positive, negative, and disparate–women’s differing long-term psychosocial experiences of bilateral or contralateral prophylactic mastectomy. Breast J. 2008;14:25–32.PubMedCrossRef
10.
Frost MH, Slezak JM, Tran NV, et al. Satisfaction after contralateral prophylactic mastectomy: the significance of mastectomy type, reconstructive complications, and body appearance. J Clin Oncol. 2005;23:7849–56.PubMedCrossRef
11.
Isern AE, Tengrup I, Loman N, Olsson H, Ringberg A. Aesthetic outcome, patient satisfaction, and health-related quality of life in women at high risk undergoing prophylactic mastectomy and immediate breast reconstruction. J Plast Reconstr Aesthet Surg. 2008;61:1177–87.PubMedCrossRef
12.
Geiger AM, West CN, Nekhlyudov L, et al. Contentment with quality of life among breast cancer survivors with and without contralateral prophylactic mastectomy. J Clin Oncol. 2006;24:1350–6.PubMedCrossRef
13.
Montgomery LL, Tran KN, Heelan MC, et al. Issues of regret in women with contralateral prophylactic mastectomies. Ann Surg Oncol. 1999;6:546–52.PubMedCrossRef
14.
Bresser PJ, Van Gool AR, Seynaeve C, et al. Who is prone to high levels of distress after prophylactic mastectomy and/or salpingo-ovariectomy? Ann Oncol. 2007;18:1641–5.PubMedCrossRef
15.
Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer. 2001;37:189–97.PubMedCrossRef
16.
Stewart A, Ware J. Measuring functioning and well-being. Durham: Duke University Press; 1992.
17.
Spielberger C. State-Trait Anxiety Inventory: STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press, Inc.; 1983.
18.
Herzberg PY, Glaesmer H, Hoyer J. Separating optimism and pessimism: a robust psychometric analysis of the revised Life Orientation Test (LOT-R). Psychol Assess. 2006;18:433–8.PubMedCrossRef
19.
Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994;67:1063–78.PubMedCrossRef
20.
21.
van Dijk S, van Roosmalen MS, Otten W, Stalmeier PF. Decision making regarding prophylactic mastectomy: stability of preferences and the impact of anticipated feelings of regret. J Clin Oncol. 2008;26:2358–63.PubMedCrossRef
22.
Borgen PI, Hill AD, Tran KN, et al. Patient regrets after bilateral prophylactic mastectomy. Ann Surg Oncol. 1998;5:603–6.PubMedCrossRef
23.
Hatcher MB, Fallowfield L, A’Hern R. The psychosocial impact of bilateral prophylactic mastectomy: prospective study using questionnaires and semistructured interviews. BMJ. 2001;322:76.PubMedCrossRef
24.
Bresser PJ, Seynaeve C, Van Gool AR, et al. Satisfaction with prophylactic mastectomy and breast reconstruction in genetically predisposed women. Plast Reconstr Surg. 2006;117:1675–82; discussion 83–4.PubMedCrossRef
25.
Tercyak KP, Peshkin BN, Brogan BM, et al. Quality of life after contralateral prophylactic mastectomy in newly diagnosed high-risk breast cancer patients who underwent BRCA1/2 gene testing. J Clin Oncol. 2007;25:285–91.PubMedCrossRef
26.
Sprangers MA, Schwartz CE. Reflections on changeability versus stability of health-related quality of life: distinguishing between its environmental and genetic components. Health Qual Life Outcomes. 2008;6:89.PubMedCrossRef
Metadata
Title
Contralateral Prophylactic Mastectomy: Long-Term Consistency of Satisfaction and Adverse Effects and the Significance of Informed Decision-Making, Quality of Life, and Personality Traits
Authors
Marlene H. Frost, PhD
Tanya L. Hoskin, MS
Lynn C. Hartmann, MD
Amy C. Degnim, MD
Joanne L. Johnson, RN
Judy C. Boughey, MD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1917-7

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