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Perceptions of Contralateral Breast Cancer Risk: A Prospective, Longitudinal Study

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

An increasing proportion of breast cancer patients undergo contralateral prophylactic mastectomy (CPM) to reduce their risk of contralateral breast cancer (CBC). Our goal was to evaluate CBC risk perception changes over time among breast cancer patients.

Methods

We conducted a prospective, longitudinal study of women with newly diagnosed unilateral breast cancer. Patients completed a survey before and approximately 2 years after treatment. Survey questions used open-ended responses or 5-point Likert scale scoring (e.g., 5 = very likely, 1 = not at all likely).

Results

A total of 74 women completed the presurgical treatment survey, and 43 completed the postsurgical treatment survey. Baseline characteristics were not significantly different between responders and nonresponders of the follow-up survey. The mean estimated 10-year risk of CBC was 35.7 % on the presurgical treatment survey and 13.8 % on the postsurgical treatment survey (p < 0.001). The perceived risks of developing cancer in the same breast and elsewhere in the body significantly decreased between surveys. Both CPM and non-CPM (breast-conserving surgery or unilateral mastectomy) patients’ perceived risk of CBC significantly decreased from pre- to postsurgical treatment surveys. Compared with non-CPM patients, CPM patients had a significantly lower perceived 10-year risk of CBC (5.8 vs. 17.3 %, p = 0.046) on postsurgical treatment surveys.

Conclusions

The perceived risk of CBC significantly attenuated over time for both CPM and non-CPM patients. These data emphasize the importance of early physician counseling and improvement in patient education to provide women with accurate risk information before they make surgical treatment decisions.

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References

  1. Early Breast Cancer Trialists’ Collaborative G, Davies C, Godwin J, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011;378:771–84.

    Article  Google Scholar 

  2. Nichols HB, Berrington de Gonzalez A, Lacey JV, Jr., Rosenberg PS, Anderson WF. Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol. 2011;29:1564–9.

    Article  Google Scholar 

  3. King TA, Sakr R, Patil S, et al. Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol. 2011;29:2158–64.

    Article  PubMed  Google Scholar 

  4. McLaughlin CC, Lillquist PP, Edge SB. Surveillance of prophylactic mastectomy: trends in use from 1995 through 2005. Cancer. 2009;115:5404–12.

    Article  PubMed  Google Scholar 

  5. Sorbero ME, Dick AW, Beckjord EB, Ahrendt G. Diagnostic breast magnetic resonance imaging and contralateral prophylactic mastectomy. Ann Surg Oncol. 2009;16:1597–605.

    Article  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. Yao K, Stewart AK, Winchester DJ, Winchester DP. Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998-2007. Ann Surg Oncol. 2010;17:2554–62.

    Article  PubMed  Google Scholar 

  9. Abbott A, Rueth N, Pappas-Varco S, Kuntz K, Kerr E, Tuttle T. Perceptions of contralateral breast cancer: an overestimation of risk. Ann Surg Oncol. 2011;18:3129–36.

    Article  PubMed  Google Scholar 

  10. Rakovitch E, Franssen E, Kim J, et al. A comparison of risk perception and psychological morbidity in women with ductal carcinoma in situ and early invasive breast cancer. Breast Cancer Res Treat. 2003;77:285–93.

    Article  PubMed  Google Scholar 

  11. Yi M, Hunt KK, Arun BK, et al. Factors affecting the decision of breast cancer patients to undergo contralateral prophylactic mastectomy. Cancer Prev Res. 2010;3(8):1026–34.

    Article  Google Scholar 

  12. Rosenberg SM, Tracy MS, Meyer ME, et al. Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: a cross-sectional survey. Ann Intern Med. 2013;159:373–81.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Liu Y, Perez M, Schootman M, et al. A longitudinal study of factors associated with perceived risk of recurrence in women with ductal carcinoma in situ and early-stage invasive breast cancer. Breast Cancer Res Treat. 2010;124:835–44.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Partridge A, Adloff K, Blood E, et al. Risk perceptions and psychosocial outcomes of women with ductal carcinoma in situ: longitudinal results from a cohort study. J Natl Cancer Inst. 2008;100:243–51.

    Article  PubMed  Google Scholar 

  15. Alexander NE, Ross J, Sumner W, Nease RF, Jr., Littenberg B. The effect of an educational intervention on the perceived risk of breast cancer. J Gen Intern Med. 1996;11:92–7.

    Article  CAS  PubMed  Google Scholar 

  16. Quillin JM, McClish DK, Jones RM, et al. Duration of an intervention’s impact on perceived breast cancer risk. Health Educ Behav. 2008;35:855–65.

    Article  PubMed  Google Scholar 

  17. Goldflam K, Hunt KK, Gershenwald JE, et al. Contralateral prophylactic mastectomy. Predictors of significant histologic findings. Cancer. 2004;101:1977–86.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. Montgomery LL, Tran KN, Heelan MC, et al. Issues of regret in women with contralateral prophylactic mastectomies. Ann Surg Oncol. 1999;6:546–52.

    Article  CAS  PubMed  Google Scholar 

  21. 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.

    Article  PubMed  Google Scholar 

  22. 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.

    CAS  PubMed  Google Scholar 

  23. 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.

    Article  CAS  PubMed  Google Scholar 

  24. 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.

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Minnesota, Minneapolis, MN, USA

    Pamela R. Portschy MD, MS, Erin E. Burke MD, Rumbidzayi Nzara BA, Schelomo Marmor PhD, MPH & Todd M. Tuttle MD, MS

  2. Department of Surgical Oncology, Moffitt Cancer Center, Tampa, USA

    Andrea M. Abbott MD, MS

  3. Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    Karen M. Kuntz ScD

Authors
  1. Pamela R. Portschy MD, MS
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  2. Andrea M. Abbott MD, MS
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  3. Erin E. Burke MD
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  4. Rumbidzayi Nzara BA
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  5. Schelomo Marmor PhD, MPH
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  6. Karen M. Kuntz ScD
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  7. Todd M. Tuttle MD, MS
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Corresponding author

Correspondence to Todd M. Tuttle MD, MS.

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Portschy, P.R., Abbott, A.M., Burke, E.E. et al. Perceptions of Contralateral Breast Cancer Risk: A Prospective, Longitudinal Study. Ann Surg Oncol 22, 3846–3852 (2015). https://doi.org/10.1245/s10434-015-4442-2

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  • DOI: https://doi.org/10.1245/s10434-015-4442-2

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