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Quality of life among patients after bilateral prophylactic mastectomy: a systematic review of patient-reported outcomes

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Abstract

Purpose

Bilateral prophylactic mastectomy (BPM) is effective in reducing the risk of breast cancer in women with a well-defined family history of breast cancer or in women with BRCA 1 or 2 mutations. Evaluating patient-reported outcomes following BPM are thus essential for evaluating success of BPM from patient’s perspective. Our systematic review aimed to: (1) identify studies describing health-related quality of life (HRQOL) in patients following BPM with or without reconstruction; (2) assess the effect of BPM with or without reconstruction on HRQOL; and (3) identify predictors of HRQOL post-BPM.

Methods

We performed a systematic review of literature using the PRISMA guidelines. PubMed, Embase, PsycINFO, Web of Science, Scopus and Cochrane databases were searched.

Results

The initial search resulted in 1082 studies; 22 of these studies fulfilled our inclusion criteria. Post-BPM, patients are satisfied with the outcomes and report high psychosocial well-being and positive body image. Sexual well-being and somatosensory function are most negatively affected. Vulnerability, psychological distress and preoperative cancer distress are significant negative predictors of quality of life and body image post-BPM.

Conclusion

There is a paucity of high-quality data on outcomes of different HRQOL domains post-BPM. Future studies should strive to use validated and breast-specific PRO instruments for measuring HRQOL. This will facilitate shared decision-making by enabling surgeons to provide evidence-based answers to women contemplating BPM.

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Author information

Authors and Affiliations

  1. Plastic and Reconstructive Surgical Service, 1275 York Avenue, MRI 1007, New York, NY, 10065, USA

    Shantanu N. Razdan

  2. Weil Cornell Medical College, New York, NY, USA

    Vishal Patel

  3. Memorial Sloan Kettering Cancer Center Library, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sarah Jewell

  4. Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, MRI-1007, New York, NY, 10065, USA

    Colleen M. McCarthy

Authors
  1. Shantanu N. Razdan
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  2. Vishal Patel
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  4. Colleen M. McCarthy
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Corresponding author

Correspondence to Shantanu N. Razdan.

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Conflict of interest

Shantanu N. Razdan declares that he has no conflict of interest. Vishal Patel declares that he has no conflict of interest. Sarah Jewell declares that she has no conflict of interest. Colleen M. McCarthy declares that she has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Razdan, S.N., Patel, V., Jewell, S. et al. Quality of life among patients after bilateral prophylactic mastectomy: a systematic review of patient-reported outcomes. Qual Life Res 25, 1409–1421 (2016). https://doi.org/10.1007/s11136-015-1181-6

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  • DOI: https://doi.org/10.1007/s11136-015-1181-6

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