Impact of Reconstruction and Reoperation on Long-Term Patient-Reported Satisfaction After Contralateral Prophylactic Mastectomy

Judy C Boughey, Tanya L. Hoskin, Lynn C. Hartmann, Joanne L. Johnson, Steven R. Jacobson, Amy C Degnim, Marlene H. Frost

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Abstract

Background: Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.

Methods: 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960 and 1993 were surveyed regarding quality of life (QOL) and satisfaction with CPM at two time points (approximately 10 and 20 years after CPM).

Results: 583 women responded to the first follow-up questionnaire (median 10.7 years; mean 11.9 years) after CPM. There were 403 (69 %) patients who underwent reconstruction and 180 (31 %) patients who did not. Women electing reconstruction were younger [mean age 47 versus (vs.) 53 years; p = 0.01] and more likely to be married (85 vs. 78 %; p = 0.048). Most women reported satisfaction with CPM (83 %), and they would choose CPM again (84 %) and make the same choice regarding reconstruction (73 %). However, reconstruction patients demonstrated significantly lower satisfaction (p = 0.0001) and were less likely to choose CPM again (p < 0.0001). Within the reconstruction group, 39 % needed 1 + unplanned reoperation, which was strongly associated with lower satisfaction (p = 0.0001), lower likelihood of choosing CPM again (p = 0.006), and lower likelihood of choosing reconstruction again (p < 0.0001). There were 269 women who responded to the second questionnaire (median 18.4 years; mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92 % of the women stating they would choose CPM again.

Conclusions: Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.

Original languageEnglish (US)
Pages (from-to)401-408
Number of pages8
JournalAnnals of Surgical Oncology
Volume22
Issue number2
DOIs
StatePublished - 2014

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Patient Satisfaction
Reoperation
Prophylactic Mastectomy
Breast Neoplasms
Quality of Life

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Impact of Reconstruction and Reoperation on Long-Term Patient-Reported Satisfaction After Contralateral Prophylactic Mastectomy. / Boughey, Judy C; Hoskin, Tanya L.; Hartmann, Lynn C.; Johnson, Joanne L.; Jacobson, Steven R.; Degnim, Amy C; Frost, Marlene H.

In: Annals of Surgical Oncology, Vol. 22, No. 2, 2014, p. 401-408.

Research output: Contribution to journalArticle

Boughey, Judy C ; Hoskin, Tanya L. ; Hartmann, Lynn C. ; Johnson, Joanne L. ; Jacobson, Steven R. ; Degnim, Amy C ; Frost, Marlene H. / Impact of Reconstruction and Reoperation on Long-Term Patient-Reported Satisfaction After Contralateral Prophylactic Mastectomy. In: Annals of Surgical Oncology. 2014 ; Vol. 22, No. 2. pp. 401-408.
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abstract = "Background: Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.Methods: 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960 and 1993 were surveyed regarding quality of life (QOL) and satisfaction with CPM at two time points (approximately 10 and 20 years after CPM).Results: 583 women responded to the first follow-up questionnaire (median 10.7 years; mean 11.9 years) after CPM. There were 403 (69 {\%}) patients who underwent reconstruction and 180 (31 {\%}) patients who did not. Women electing reconstruction were younger [mean age 47 versus (vs.) 53 years; p = 0.01] and more likely to be married (85 vs. 78 {\%}; p = 0.048). Most women reported satisfaction with CPM (83 {\%}), and they would choose CPM again (84 {\%}) and make the same choice regarding reconstruction (73 {\%}). However, reconstruction patients demonstrated significantly lower satisfaction (p = 0.0001) and were less likely to choose CPM again (p < 0.0001). Within the reconstruction group, 39 {\%} needed 1 + unplanned reoperation, which was strongly associated with lower satisfaction (p = 0.0001), lower likelihood of choosing CPM again (p = 0.006), and lower likelihood of choosing reconstruction again (p < 0.0001). There were 269 women who responded to the second questionnaire (median 18.4 years; mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92 {\%} of the women stating they would choose CPM again.Conclusions: Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.",
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T1 - Impact of Reconstruction and Reoperation on Long-Term Patient-Reported Satisfaction After Contralateral Prophylactic Mastectomy

AU - Boughey, Judy C

AU - Hoskin, Tanya L.

AU - Hartmann, Lynn C.

AU - Johnson, Joanne L.

AU - Jacobson, Steven R.

AU - Degnim, Amy C

AU - Frost, Marlene H.

PY - 2014

Y1 - 2014

N2 - Background: Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.Methods: 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960 and 1993 were surveyed regarding quality of life (QOL) and satisfaction with CPM at two time points (approximately 10 and 20 years after CPM).Results: 583 women responded to the first follow-up questionnaire (median 10.7 years; mean 11.9 years) after CPM. There were 403 (69 %) patients who underwent reconstruction and 180 (31 %) patients who did not. Women electing reconstruction were younger [mean age 47 versus (vs.) 53 years; p = 0.01] and more likely to be married (85 vs. 78 %; p = 0.048). Most women reported satisfaction with CPM (83 %), and they would choose CPM again (84 %) and make the same choice regarding reconstruction (73 %). However, reconstruction patients demonstrated significantly lower satisfaction (p = 0.0001) and were less likely to choose CPM again (p < 0.0001). Within the reconstruction group, 39 % needed 1 + unplanned reoperation, which was strongly associated with lower satisfaction (p = 0.0001), lower likelihood of choosing CPM again (p = 0.006), and lower likelihood of choosing reconstruction again (p < 0.0001). There were 269 women who responded to the second questionnaire (median 18.4 years; mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92 % of the women stating they would choose CPM again.Conclusions: Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.

AB - Background: Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.Methods: 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960 and 1993 were surveyed regarding quality of life (QOL) and satisfaction with CPM at two time points (approximately 10 and 20 years after CPM).Results: 583 women responded to the first follow-up questionnaire (median 10.7 years; mean 11.9 years) after CPM. There were 403 (69 %) patients who underwent reconstruction and 180 (31 %) patients who did not. Women electing reconstruction were younger [mean age 47 versus (vs.) 53 years; p = 0.01] and more likely to be married (85 vs. 78 %; p = 0.048). Most women reported satisfaction with CPM (83 %), and they would choose CPM again (84 %) and make the same choice regarding reconstruction (73 %). However, reconstruction patients demonstrated significantly lower satisfaction (p = 0.0001) and were less likely to choose CPM again (p < 0.0001). Within the reconstruction group, 39 % needed 1 + unplanned reoperation, which was strongly associated with lower satisfaction (p = 0.0001), lower likelihood of choosing CPM again (p = 0.006), and lower likelihood of choosing reconstruction again (p < 0.0001). There were 269 women who responded to the second questionnaire (median 18.4 years; mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92 % of the women stating they would choose CPM again.Conclusions: Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.

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