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Satisfaction and Well-Being After Contralateral Prophylactic Mastectomy Among BRCA Mutation Carriers and Noncarriers: A Longitudinal Analysis of BREAST-Q Domains

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

Abstract

Introduction

Contralateral prophylactic mastectomy (CPM) is recommended for BRCA mutation carriers; its use in noncarriers relies on patient choice. We characterized differences in satisfaction and well-being after CPM between BRCA carriers and noncarriers.

Methods

BREAST-Q data were obtained before and after CPM with immediate reconstruction performed at a single institution from 2016 to 2022. Associations between BRCA status and satisfaction with breasts, psychosocial well-being, and sexual well-being were assessed, with adjustment for preoperative scores and relevant confounders.

Results

In total, 149 BRCA carriers and 842 noncarriers were included. Response rates varied over time (preoperative, 56%; 6 months, 78%; 1 year, 51%; 2 years, 52%; 3 years, 59%). BRCA carriers were younger (p < 0.001), with a higher rate of neoadjuvant chemotherapy (p < 0.001). More noncarriers had HR+/HER2- tumors (p < 0.001) and underwent endocrine therapy (p < 0.001). Baseline satisfaction with breasts was higher among BRCA carriers (median [interquartile range] score, 70 [53–82] vs. 58 [48–70]; p = 0.006); psychosocial (p = 0.20) and sexual (p = 0.14) well-being were not significantly different between groups. BRCA carriers had a greater decrease in satisfaction with breasts (p = 0.04) and psychological well-being (p = 0.05) from baseline to 6 months; decrease in sexual well-being (p = 0.38) was not significantly different between groups. On univariate and multivariable analyses, BRCA status was not associated with satisfaction with breasts, sexual well-being, or psychosocial well-being.

Conclusions

Satisfaction and well-being were similar between BRCA carriers and noncarriers treated with CPM. Relative to noncarriers, BRCA carriers experienced a greater decline in satisfaction with breasts and psychological well-being at 6 months after CPM.

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Acknowledgement

We acknowledge the significant contribution of Tajah Bell, Department of Plastic Surgery Research Project Manager.

Funding

The preparation of this study was supported, in part, by the National Institutes of Health/National Cancer Institute (Cancer Center Support Grant P30 CA008748 to Memorial Sloan Kettering Cancer Center).

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sara P. Myers MD, PhD, Audree B. Tadros MD, MPH, Tiana Le BS, Paula Garcia MHA, Monica Morrow MD & Minna K. Lee MD

  2. Biostatistical Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Varadan Sevilimedu MBBS, DrPH

  3. Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jonas A. Nelson MD

Authors
  1. Sara P. Myers MD, PhD
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  2. Audree B. Tadros MD, MPH
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  3. Varadan Sevilimedu MBBS, DrPH
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  4. Jonas A. Nelson MD
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  5. Tiana Le BS
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  6. Paula Garcia MHA
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  7. Monica Morrow MD
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  8. Minna K. Lee MD
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Corresponding author

Correspondence to Minna K. Lee MD.

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Disclosures

The authors have no relevant disclosures or conflicts of interest to disclose. The preparation of this study was supported, in part, by the National Institutes of Health/National Cancer Institute (Cancer Center Support Grant P30 CA008748 to Memorial Sloan Kettering Cancer Center).

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Myers, S.P., Tadros, A.B., Sevilimedu, V. et al. Satisfaction and Well-Being After Contralateral Prophylactic Mastectomy Among BRCA Mutation Carriers and Noncarriers: A Longitudinal Analysis of BREAST-Q Domains. Ann Surg Oncol 30, 7116–7123 (2023). https://doi.org/10.1245/s10434-023-14086-y

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  • DOI: https://doi.org/10.1245/s10434-023-14086-y

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