High satisfaction rate ten years after bilateral prophylactic mastectomy - a longitudinal study.

Women from families with an increased risk for breast/ovarian cancer have undergone bilateral prophylactic mastectomy (BPM) since the early 1990s at the Karolinska University Hospital in Sweden. Perceptions of BPM as reported by the first women who underwent the procedure have previously been evaluated on a short-term basis (1-3 years). The present study aims to evaluate the long-term (10 years) physical and psychological consequences of BPM in the same cohort of women. Some of the very first women to undergo BPM participated in the present interview study (n= 13). The semi-structured interviews focused on the women's long-term experiences related to BPM and immediate breast reconstruction. Overall, the women were satisfied with their decision to undergo BPM and perceived a negligible remaining risk of getting breast cancer. For most women, the operation had not resulted in changes in family life or lifestyle (n= 8), although some described that the relationship with their spouse was affected (8/13), either in a negative (n= 5) or positive (n= 3) way. The cosmetic results were mainly positive (n= 10). Recurrent counselling and support during the whole process of decision, treatment and follow up is recommended.

[1]  N. Carbine,et al.  Prophylactic mastectomy for the prevention of breast cancer. , 2010, The Cochrane database of systematic reviews.

[2]  M. Wickman,et al.  Patient satisfaction with aesthetic outcome after bilateral prophylactic mastectomy and immediate reconstruction with implants. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[3]  J. Klijn,et al.  Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy , 2009, Hereditary cancer in clinical practice.

[4]  Annika Lindblom,et al.  Psychological reactions, quality of life, and body image after bilateral prophylactic mastectomy in women at high risk for breast cancer: a prospective 1-year follow-up study. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  Sarah M. Greene,et al.  What Women Wish They Knew Before Prophylactic Mastectomy , 2007, Cancer nursing.

[6]  P. Hansson,et al.  Long‐Term Sensibility Following Nonautologous, Immediate Breast Reconstruction , 2007, The breast journal.

[7]  J. Klijn,et al.  Prophylactic Mastectomy in BRCA1/2 Mutation Carriers and Women at Risk of Hereditary Breast Cancer: Long-Term Experiences at the Rotterdam Family Cancer Clinic , 2007, Annals of Surgical Oncology.

[8]  J. Lubiński,et al.  A survey of preventive measures among BRCA1 mutation carriers from Poland , 2007, Clinical genetics.

[9]  Sarah M. Greene,et al.  Quality of Life After Bilateral Prophylactic Mastectomy , 2007, Annals of Surgical Oncology.

[10]  P. Hansson,et al.  Sensitivity after bilateral prophylactic mastectomy and immediate reconstruction , 2007, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[11]  A. McGaughey Body image after bilateral prophylactic mastectomy: an integrative literature review. , 2006, Journal of midwifery & women's health.

[12]  K. Sandelin,et al.  Technical aspects of immediate breast reconstruction with implants: Five year follow-up , 2005, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[13]  K. Sandelin,et al.  Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective study. , 2005, Breast.

[14]  S. Spear,et al.  Prophylactic Mastectomy: Indications, Options, and Reconstructive Alternatives , 2005, Plastic and reconstructive surgery.

[15]  Susan L Neuhausen,et al.  Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  P. Hall,et al.  Preoperative psychological reactions and quality of life among women with an increased risk of breast cancer who are considering a prophylactic mastectomy. , 2004, European journal of cancer.

[17]  T. Sellers,et al.  Efficacy of bilateral prophylactic mastectomy in BRCA1 and BRCA2 gene mutation carriers. , 2001, Journal of the National Cancer Institute.

[18]  J. Klijn,et al.  Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation. , 2001, The New England journal of medicine.

[19]  A. Howell,et al.  Clinical follow‐up after bilateral risk reducing (‘prophylactic’) mastectomy: mental health and body image outcomes , 2000, Psycho-oncology.

[20]  T. Sellers,et al.  Long-term satisfaction and psychological and social function following bilateral prophylactic mastectomy. , 2000, JAMA.

[21]  K. Sandelin,et al.  Initial experiences of women from hereditary breast cancer families after bilateral prophylactic mastectomy: a retrospective study. , 2000, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[22]  P. Borgen,et al.  Women’s Regrets After Bilateral Prophylactic Mastectomy , 2000, Annals of Surgical Oncology.

[23]  D J Schaid,et al.  Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. , 1999, The New England journal of medicine.

[24]  A. Hill,et al.  Patient regrets after bilateral prophylactic mastectomy , 1998, Annals of Surgical Oncology.

[25]  S. Narod,et al.  The use of preventive measures among healthy women who carry a BRCA1 or BRCA2 mutation , 2005, Familial Cancer.