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Annals of Surgical Oncology

, Volume 24, Issue 9, pp 2502–2508 | Cite as

Impact of Bilateral Prophylactic Mastectomy and Immediate Reconstruction on Health-Related Quality of Life in Women at High Risk for Breast Carcinoma: Results of the Mastectomy Reconstruction Outcomes Consortium Study

  • Colleen M. McCarthy
  • Jennifer B. Hamill
  • Hyungjin Myra Kim
  • Ji Qi
  • Edwin Wilkins
  • Andrea L. Pusic
Breast Oncology

Abstract

Background

Although bilateral prophylactic mastectomy (BPM) can reduce the risk of breast cancer, the decision to proceed surgically can have significant consequences and requires careful deliberation. To facilitate decision making for women at high risk for breast carcinoma, the risks and benefits of BPM should be well-elucidated. We sought to determine the effects of BPM and immediate reconstruction on health-related quality-of-life outcomes among a multisite cohort of women at high risk for breast carcinoma.

Methods

Patient-reported outcome data were prospectively collected as part of the Mastectomy Reconstruction Outcomes Consortium Study, and data on a subgroup of 204 high-risk women who elected to have BPM and immediate reconstruction were evaluated. Baseline scores were compared with scores at 1 or 2 years after reconstruction.

Results

Satisfaction with breasts and psychosocial well-being were significantly higher at both 1 and 2 years (p < 0.01); however, anxiety was significantly lower at 1 or 2 years (p < 0.01) and physical well-being of the chest and upper body was significantly worse at 1 year (p < 0.01).

Conclusion

Our results highlight the impact of BPM and immediate reconstruction on health-related quality-of-life outcomes in this setting. BPM and reconstruction can result in significant, positive, lasting changes in a woman’s satisfaction with her breasts, as well as her psychosocial well-being. Furthermore, presurgery anxiety was significantly reduced by 1 year post-reconstruction and remained reduced at 2 years. With this knowledge, women at high risk for breast carcinoma, and their providers, will be better equipped to make the best individualized treatment decisions.

Notes

Funding

This study was supported by NIH/NCI grant R01 CA152192 and, in part, by NIH/NCI Cancer Center support Grant P30 CA008748 (to CMM and ALP).

Disclosures

The BREAST-Q is owned by Memorial Sloan Kettering Cancer Center and University of British Columbia.

Supplementary material

10434_2017_5915_MOESM1_ESM.docx (31 kb)
Supplemental Figure 1. Study flow diagram Supplementary material 1 (DOCX 30 kb)

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Colleen M. McCarthy
    • 1
  • Jennifer B. Hamill
    • 2
  • Hyungjin Myra Kim
    • 3
  • Ji Qi
    • 2
  • Edwin Wilkins
    • 2
  • Andrea L. Pusic
    • 1
  1. 1.Plastic and Reconstructive Surgical Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Section of Plastic Surgery, Department of SurgeryUniversity of Michigan Health SystemAnn ArborUSA
  3. 3.Center for Statistical Consultation and ResearchUniversity of MichiganAnn ArborUSA

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