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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2017

01-06-2017 | Breast Oncology

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

Authors: Chelsea Anderson, MPH, Jessica Y. Islam, MPH, M. Elizabeth Hodgson, PhD, Susan A. Sabatino, PhD, Juan L. Rodriguez, MPH, MS, Clara N. Lee, MD, MPP, Dale P. Sandler, PhD, Hazel B. Nichols, PhD

Published in: Annals of Surgical Oncology | Issue 6/2017

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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.
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Metadata
Title
Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy
Authors
Chelsea Anderson, MPH
Jessica Y. Islam, MPH
M. Elizabeth Hodgson, PhD
Susan A. Sabatino, PhD
Juan L. Rodriguez, MPH, MS
Clara N. Lee, MD, MPP
Dale P. Sandler, PhD
Hazel B. Nichols, PhD
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5753-7

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