Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy
Identifieur interne : 006A77 ( Ncbi/Checkpoint ); précédent : 006A76; suivant : 006A78Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy
Auteurs : Judy C. Boughey [États-Unis] ; Tanya L. Hoskin [États-Unis] ; Lynn C. Hartmann [États-Unis] ; Joanne L. Johnson [États-Unis] ; Steven R. Jacobson [États-Unis] ; Amy C. Degnim [États-Unis] ; Marlene H. Frost [États-Unis]Source :
- Annals of surgical oncology [ 1068-9265 ] ; 2014.
Abstract
Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.
621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960–1993 were surveyed regarding QOL and satisfaction with CPM at two time points - approximately 10 years and 20 years after CPM.
583 women responded to the first follow-up questionnaire (median 10.7 years, mean 11.9 years) after CPM. 403 (69%) underwent reconstruction and 180 (31%) did not. Women electing reconstruction were younger (mean age 47 vs 53 years, p=0.01) and more likely to be married (85% vs 78%, p=0.048). Most women reported satisfaction with CPM (83%), that they would choose CPM again (84%) and make the same choice regarding reconstruction (73%). However, reconstruction patients demonstrated significantly lower satisfaction (p=0.0001) and were less likely to choose CPM again (p<0.0001). Within the reconstruction group, 39% needed 1+ unplanned reoperation, and this was strongly associated with lower satisfaction (p=0.0001), lower likelihood of choosing CPM again (p=0.006) and lower likelihood of choosing reconstruction again (p<0.0001). 269 women responded to the second questionnaire (median 18.4 years, mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92% of women stating they would choose CPM again.
Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.
Url:
DOI: 10.1245/s10434-014-4053-3
PubMed: 25192678
PubMed Central: 4498460
Affiliations:
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<author><name sortKey="Boughey, Judy C" sort="Boughey, Judy C" uniqKey="Boughey J" first="Judy C." last="Boughey">Judy C. Boughey</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy</title>
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<series><title level="j">Annals of surgical oncology</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960–1993 were surveyed regarding QOL and satisfaction with CPM at two time points - approximately 10 years and 20 years after CPM.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">583 women responded to the first follow-up questionnaire (median 10.7 years, mean 11.9 years) after CPM. 403 (69%) underwent reconstruction and 180 (31%) did not. Women electing reconstruction were younger (mean age 47 vs 53 years, p=0.01) and more likely to be married (85% vs 78%, p=0.048). Most women reported satisfaction with CPM (83%), that they would choose CPM again (84%) and make the same choice regarding reconstruction (73%). However, reconstruction patients demonstrated significantly lower satisfaction (p=0.0001) and were less likely to choose CPM again (p<0.0001). Within the reconstruction group, 39% needed 1+ unplanned reoperation, and this was strongly associated with lower satisfaction (p=0.0001), lower likelihood of choosing CPM again (p=0.006) and lower likelihood of choosing reconstruction again (p<0.0001). 269 women responded to the second questionnaire (median 18.4 years, mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92% of women stating they would choose CPM again.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction.</p>
</sec>
</div>
</front>
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<affiliations><list><country><li>États-Unis</li>
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<tree><country name="États-Unis"><region name="Minnesota"><name sortKey="Boughey, Judy C" sort="Boughey, Judy C" uniqKey="Boughey J" first="Judy C." last="Boughey">Judy C. Boughey</name>
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<name sortKey="Degnim, Amy C" sort="Degnim, Amy C" uniqKey="Degnim A" first="Amy C." last="Degnim">Amy C. Degnim</name>
<name sortKey="Frost, Marlene H" sort="Frost, Marlene H" uniqKey="Frost M" first="Marlene H." last="Frost">Marlene H. Frost</name>
<name sortKey="Hartmann, Lynn C" sort="Hartmann, Lynn C" uniqKey="Hartmann L" first="Lynn C." last="Hartmann">Lynn C. Hartmann</name>
<name sortKey="Hoskin, Tanya L" sort="Hoskin, Tanya L" uniqKey="Hoskin T" first="Tanya L." last="Hoskin">Tanya L. Hoskin</name>
<name sortKey="Jacobson, Steven R" sort="Jacobson, Steven R" uniqKey="Jacobson S" first="Steven R." last="Jacobson">Steven R. Jacobson</name>
<name sortKey="Johnson, Joanne L" sort="Johnson, Joanne L" uniqKey="Johnson J" first="Joanne L." last="Johnson">Joanne L. Johnson</name>
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