Increasing incidence of bilateral mastectomies: the patient perspective

Am J Surg. 2011 May;201(5):615-8. doi: 10.1016/j.amjsurg.2011.01.018.

Abstract

Background: Numerous studies have reported increasing rates of contralateral prophylactic mastectomies (CPMs). Understanding patient rationale for the surgical choice may provide insight into this trend.

Methods: A questionnaire was mailed to 350 mastectomy patients identified from a community health system tumor registry.

Results: Two hundred fifty questionnaires were received; of these, 237 had undergone mastectomy. Fifty-two percent had unilateral mastectomy (UM), and 43% had bilateral mastectomies (BMs) (6% for bilateral disease). Women younger than 60 years of age were more likely to choose BM (P = .0046). Those who had CPM were significantly more likely to make the same surgical decision (P < .0001). Reconstruction was performed in 52%, with BM patients more likely to undergo reconstruction (P = .009). Twenty-three (19%) needed unanticipated reoperation for reconstruction complications. CPM had equivalent rates of unanticipated surgery versus UM (P = .64).

Conclusions: Patients choosing BMs are younger, have equivalent rates of reoperation because of reconstruction complications, and are significantly more satisfied with their decision than those who chose UM.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / prevention & control
  • Breast Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Mastectomy / trends*
  • Middle Aged
  • Prognosis
  • Registries / statistics & numerical data*
  • Retrospective Studies
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult