Long-term patient-reported satisfaction after contralateral prophylactic mastectomy and implant reconstruction Journal Article


Authors: Koslow, S.; Pharmer, L. A.; Scott, A. M.; Stempel, M.; Morrow, M.; Pusic, A. L.; King, T. A.
Article Title: Long-term patient-reported satisfaction after contralateral prophylactic mastectomy and implant reconstruction
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. © 2013 Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 20
Issue: 11
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2013-10-01
Start Page: 3422
End Page: 3429
Language: English
DOI: 10.1245/s10434-013-3026-2
PROVIDER: scopus
PUBMED: 23720070
DOI/URL:
Notes: --- - "Export Date: 1 October 2013" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Monica Morrow
    535 Morrow
  2. Andrea Pusic
    292 Pusic
  3. Tari King
    176 King
  4. Amie Marie Scott
    45 Scott
  5. Michelle Moccio Stempel
    153 Stempel
  6. Starr Britni Koslow
    15 Koslow