Long-term Satisfaction and Psychological and Social Function Following Bilateral Prophylactic Mastectomy

Reviewers: Li Liu, MD
Source: JAMA Volume 284(3): 319-324, (July) 2000

Précis: High satisfaction following prophylactic bilateral mastectomy

Introduction

The improved availability to identify women at high risk for breast cancer, such as through genetic testing for BRCA1 and BRCA2 mutation, has intensified the need to define the benefits and risks of early detection and protective measures for such women. Prophylactic mastectomy is one option for preventing breast cancer in women at high risk for the disease. However, the social and psychological impact of bilateral mastectomy in women with breast cancer remains unclear. In this study, researchers assessed psychosocial and social outcomes, and overall satisfaction of prophylactic mastectomy.

Method

A total of 572 women with a family history of breast cancer who had a bilateral prophylactic mastectomy between 1960 and 1993 were included.

Results

After a mean follow-up of 14.5 years,

• 72% of women reported satisfaction with the procedure and 74% were less concerned about developing breast cancer.
• Two-thirds of the women said that they definitely or probably would choose to have a prophylactic mastectomy again.
• There were either no changes or an improvement in the level of emotional stability, level of stress, self-esteem, sexual relationships, feelings of femininity and satisfaction with body appearance in the majority of women.

Discussion

In the study, most women were satisfied after bilateral prophylactic mastectomy and report much less concern about developing breast cancer.