Contralateral Prophylactic Mastectomy in Breast Cancer: More Information
Take-Home Message:
Women with breast cancer who choose contralateral prophylactic mastectomy (CPM) tend to have more anxiety before surgery and poor quality of life following surgery.
Prospective Study of Psychosocial Outcomes of Having Contralateral Prophylactic Mastectomy Among Women With Nonhereditary Breast Cancer
Authors: Parker, P.A. et. al.
Source: J Clin Oncol http://ascopubs.org/doi/10.1200/JCO.2018.78.6442
Women who are surgical candidates for breast cancer treatment often have a choice between lumpectomy and mastectomy for their care. While CPM does not affect cancer-related outcomes, many women consider this as an additional option in their cancer treatment plan. Studies have explored the factors that lead to this decision, as well as the effects of CPM on women’s lives.
This recent study reviewed women with stages I-III breast cancer between March 2014 and December 2015. Almost 300 patients participated. Compared to women who did not choose CPM, the women who chose to proceed with CPM had higher rates of cancer-related distress and worry, as well as greater concerns about body image. The women who proceeded to CPM also had a poorer quality of life preoperatively.
Women who received CPM had greater worry about their diagnosis before surgery. Postoperatively, their level of worry decreased over time and became equivalent to that of the women who did not choose CPM. However, women who underwent CPM had persistently lower quality of life in the postoperative period.
The investigators noted that the information discovered in this study is helpful for breast cancer physicians when counseling their patients. An awareness of patient anxiety as well as other factors that affect quality of life will be helpful in counseling patients about the risks of CPM.