Decision making and factors influencing long-term satisfaction with prophylactic mastectomy in women with breast cancer

Am J Clin Oncol. 2015 Apr;38(2):179-83. doi: 10.1097/COC.0b013e318292f8a7.


Purpose: Studies demonstrate an increasing rate of contralateral prophylactic mastectomy (CPM). The purpose of this study is to evaluate decision making and factors influencing women's long-term satisfaction with CPM. Descriptive analysis is used to analyze the results of our designed questionnaire approved by our Institutional Review Board.

Methods: We searched our institutional cancer registry for patients diagnosed with breast cancer between 2000 and 2010. The studied time frame is of significance as this study is the first to measure response rate in questions examining patient satisfaction for >1 year after undergoing CPM. The questionnaire was mailed to all consented participants to examine factors contributing to the choice of CPM and postoperative satisfaction.

Results: Of the 206 women included in the study, 147 were aged up to 50 years. Majority of women who underwent CPM in this cohort was with a bachelor's degree or higher, married or partnered women, and women earning >$60,000/y. Almost all women were "happy with overall surgery" and would recommend CPM to other patients. Psychological factors, such as fear of recurrence, were more commonly associated with the decision for CPM in patients with invasive carcinoma. Opinions of partners, relatives, friends, and physicians further contributed to the decision to undergo surgery. The availability of reconstruction was also an influential factor in the overall decision.

Conclusions: The majority of our study participants experienced long-term satisfaction with the surgical procedure of CPM. From our analysis, we can confidently say that fear of cancer recurrence and the opinions of others, among other factors, were influencing contributors toward the decision of undergoing CPM.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Breast Neoplasms / prevention & control*
  • Breast Neoplasms / surgery*
  • Cohort Studies
  • Decision Making
  • Female
  • Humans
  • Mastectomy / psychology*
  • Middle Aged
  • Patient Satisfaction
  • Prophylactic Surgical Procedures / psychology*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Young Adult