Women Satisfied With Contralateral Mastectomy

Ten years after having a contralateral prophylactic mastectomy (CPM), most women reported they are satisfied and would elect the procedure again.

Following diagnosis of breast cancer, a woman has around a 15% chance of developing cancer in the other breast. In women with BRCA mutations, the risk increases to 52% over a lifetime, and for women under 40 at diagnosis, the risk is 40% within the first 10 years. To manage these risks, women may have more-frequent screenings, take chemotherapy, have a preventive removal of ovaries, or have a mastectomy of the other breast.

More than 80% of the 583 women in the study reported satisfaction with their decision, although that depended on the type of surgery. Those women who had a subcutaneous mastectomy, with about 95% of breast tissue removed, reported more problems with reconstruction, and fewer were satisfied with the procedure than those women who had a simple mastectomy with only breast tissue and nipple removed. Satisfaction levels were higher (83%) on average in women who had a single prophylactic mastectomy, compared to women who had bilateral (both breasts) prophylactic mastectomies (70%).

Among the adverse psychologic and social outcomes were negative feelings toward body appearance (33%), loss of sense of femininity (26%), negative impact on sexual relationships (23%), added stress (17%), decrease in self-esteem (17%), and decrease in emotional stability (12%).

"Clearly, a woman diagnosed with a first breast cancer who has a family history of breast cancer is faced with complex decisions about the treatment of her cancer and her risk for cancer in the other breast,” said lead investigator Marlene Frost, Ph.D., an oncology researcher at Mayo Clinic (Rochester, MN, USA). "It is important that these women have information about the probable effectiveness, as well as psychological and social outcomes, of their options.”




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