Patient reported satisfaction after prophylactic operations of the breast

Purpose:

Prophylactic mastectomies in carriers of mutations in BRCA1 or BRCA2 are becoming more and more common. We investigated outcome after prophylactic mastectomy, especially in terms of quality of life in a mono-center study.

Patients and methods:

Patients with risk criteria for hereditary breast and ovarian cancer were counselled in the Center of Dresden of GC-HBOC between 2000 and 2017. A retrospective telephone survey was performed of all patients with documented prophylactic mastectomy in our cohort. Complications and satisfaction with decision were recorded.

Results:

Out of 39 patients who opted for a prophylactic mastectomy (37 BRCA1/2-carriers and 2 non-carriers) 37 were interviewed. Mostly nipple sparing mastectomy with reconstruction was performed (87%). Half of the patients (20/37; 54%) were affected with unilateral breast cancer after initial breast conserving surgery. The median time since prophylactic mastectomy was 4,2 years. While 65% did not report any complications, flap loss was seen in 13.5% and moderate limitations in everyday life was present in 18%. An improvement of quality of life was noticed by 78% after prophylactic mastectomy and non expressed regret with regard to the decision.

Conclusion:

Prophylactic mastectomy is a procedure with risk for long term complications in some cases. Our results confirm high satisfaction with the decision with improved quality of life.