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01.10.2013 | Breast Oncology | Ausgabe 11/2013

Annals of Surgical Oncology 11/2013

Long-Term Patient-Reported Satisfaction after Contralateral Prophylactic Mastectomy and Implant Reconstruction

Annals of Surgical Oncology > Ausgabe 11/2013
MD Starr Koslow, MD Lindsay A. Pharmer, MPH Amie M. Scott, MPH Michelle Stempel, MD Monica Morrow, MD MHS Andrea L. Pusic, MD Tari A. King
Wichtige Hinweise
The first two authors contributed equally to this article and share first authorship. The last two authors contributed equally to this article and share senior authorship.
Presented in part as a poster at the 66th Society of Surgical Oncology Annual Cancer Symposium, March 6–9, 2013, National Harbor, MA.



To determine whether satisfaction and health-related quality of life (HR-QoL) differ between women who do and do not undergo contralateral prophylactic mastectomy (CPM) in the setting of implant reconstruction using the BREAST-Q, a validated patient-reported outcome instrument.


From 2000 to 2007, a total of 3,874 patients with stage 0 to III unilateral breast cancer (BC) had mastectomy; 688 (18 %) pursued CPM within 1 year. Patients who completed the BREAST-Q reconstruction module as part of BREAST-Q validation studies or routine clinical care formed our study cohort. Comparisons were made between CPM and no-CPM patients using univariate analysis and multivariate models (MVA).


Of 294 patients with BREAST-Q data, 112 (38 %) had CPM. Median time from mastectomy to BREAST-Q was 52 months. CPM patients were younger (mean 47 vs. 50 years), more likely to be White (98 vs. 86 %), married (84 vs. 71 %), have a family history of BC (60 vs. 44 %), and to choose silicone implants (67 vs. 48 %). There were no differences in tumor or treatment characteristics between groups at the time of BREAST-Q. Patients with CPM had a higher mean score for Satisfaction with Breasts (64.4 vs. 54.9; p < 0.001) and Satisfaction with Outcome (74.8 vs. 67.7; p = 0.007); other HR-QoL domains did not differ. On MVA, CPM and the absence of lymphedema were significant predictors of Satisfaction with Breasts (CPM p = 0.005, lymphedema p = 0.039). CPM was not associated with improved Satisfaction with Outcome.


This study suggests that in the setting of implant reconstruction, CPM has a positive correlation with patient satisfaction with their breasts, but not with improvements in other HR-QoL domains.

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