Satisfaction and well-being after contralateral prophylactic mastectomy among BRCA mutation carriers and noncarriers: A longitudinal analysis of BREAST-Q domains Journal Article
| Authors: | Myers, S. P.; Tadros, A. B.; Sevilimedu, V.; Nelson, J. A.; Le, T.; Garcia, P.; Morrow, M.; Lee, M. K. |
| Article Title: | Satisfaction and well-being after contralateral prophylactic mastectomy among BRCA mutation carriers and noncarriers: A longitudinal analysis of BREAST-Q domains |
| Abstract: | Introduction: Contralateral prophylactic mastectomy (CPM) is recommended for BRCA mutation carriers; its use in noncarriers relies on patient choice. We characterized differences in satisfaction and well-being after CPM between BRCA carriers and noncarriers. Methods: BREAST-Q data were obtained before and after CPM with immediate reconstruction performed at a single institution from 2016 to 2022. Associations between BRCA status and satisfaction with breasts, psychosocial well-being, and sexual well-being were assessed, with adjustment for preoperative scores and relevant confounders. Results: In total, 149 BRCA carriers and 842 noncarriers were included. Response rates varied over time (preoperative, 56%; 6 months, 78%; 1 year, 51%; 2 years, 52%; 3 years, 59%). BRCA carriers were younger (p < 0.001), with a higher rate of neoadjuvant chemotherapy (p < 0.001). More noncarriers had HR+/HER2- tumors (p < 0.001) and underwent endocrine therapy (p < 0.001). Baseline satisfaction with breasts was higher among BRCA carriers (median [interquartile range] score, 70 [53–82] vs. 58 [48–70]; p = 0.006); psychosocial (p = 0.20) and sexual (p = 0.14) well-being were not significantly different between groups. BRCA carriers had a greater decrease in satisfaction with breasts (p = 0.04) and psychological well-being (p = 0.05) from baseline to 6 months; decrease in sexual well-being (p = 0.38) was not significantly different between groups. On univariate and multivariable analyses, BRCA status was not associated with satisfaction with breasts, sexual well-being, or psychosocial well-being. Conclusions: Satisfaction and well-being were similar between BRCA carriers and noncarriers treated with CPM. Relative to noncarriers, BRCA carriers experienced a greater decline in satisfaction with breasts and psychological well-being at 6 months after CPM. © 2023, Society of Surgical Oncology. |
| Keywords: | adult; controlled study; patient satisfaction; major clinical study; genetics; mutation; adjuvant therapy; postoperative care; antineoplastic agent; preoperative evaluation; prospective study; mastectomy; psychology; breast neoplasms; brca1 protein; brca2 protein; heterozygote; cancer hormone therapy; depression; adjuvant chemotherapy; breast tumor; satisfaction; neoadjuvant chemotherapy; genetic screening; antineoplastic hormone agonists and antagonists; longitudinal study; personal satisfaction; prophylactic mastectomy; contralateral prophylactic mastectomy; triple negative breast cancer; patient-reported outcome; germline mutation; breast-q; invasive breast cancer; humans; human; female; article; hormone receptor positive breast cancer; psychological well-being; breast radiotherapy; human epidermal growth factor receptor 2 negative breast cancer; social well-being; sexual well-being |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 30 |
| Issue: | 12 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2023-11-01 |
| Start Page: | 7116 |
| End Page: | 7123 |
| Language: | English |
| DOI: | 10.1245/s10434-023-14086-y |
| PUBMED: | 37581851 |
| PROVIDER: | scopus |
| PMCID: | PMC10996069 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Minna Lee -- Source: Scopus |
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