Why do patients choose to undergo prophylactic mastectomy and reconstruction?
A study published in the July 2016 Plastic and Reconstructive Surgery Journal analyzed why some patients chose bilateral mastectomy and reconstruction even though only one side had breast cancer.
The study recruited 30 patients with stage 0 to III unilateral breast cancer who underwent breast reconstruction. The patients were then interviewed to collect patient reported outcomes using the Concerns About Recurrence Scale (assesses the extent and nature of women’s fears about the possibility of breast cancer recurrence) and the BREAST-Q (a modular, procedure-specific structure with scales that evaluate both satisfaction and quality of life).
Of the thirty patients, 13 underwent unilateral mastectomy and 17 underwent bilateral mastectomy (one side being prophylactic). After analyzing the interview responses, the study showed three broad categories emerge—Medical decision making, quality of life after mastectomy, and breast reconstruction expectations. Interestingly, patients who chose contralateral prophylactic mastectomy made their choice primarily based on worry about recurrence. The desire for symmetry was also (though not primary) a major factor in decision making.
The study concluded the choice for contralateral prophylactic mastectomy was greatly influenced by fear of recurrence with the desire for symmetry. It is also interesting to note the study found that patients choosing bilateral had a higher satisfaction scores on their overall surgical outcomes.
At PRMA, we perform both unilateral and bilateral breast reconstruction procedures for patients with unilateral breast cancer. We believe it is the patients right to be informed of all breast reconstruction options and encourage patients to consult with a plastic surgeon before their mastectomy if possible.
We would love to hear from you! If you chose contralateral prophylactic mastectomy, what led to your decision?
Author: Dr. Minas Chrysopoulo and Courtney Floyd
The study concluded the choice for contralateral prophylactic mastectomy was greatly influenced by fear of recurrence with the desire for symmetry.
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