Sacrificing a Healthy Breast: Few Regret Elective Mastectomy 20 Years Later
Survey Finds 92 Percent of Women Would Do it Again
April 29 2011
Washington - Ninety percent of breast cancer patients who elected to have a contralateral prophylactic mastectomy (removal of the second healthy breast) to minimize risk of a second cancer remained satisfied with their decision 20 years later, according to a study presented this week at the annual meeting of the American Society of Breast Surgeons (ASBrS). The research found that while many acknowledged adverse effects, the psychosocial implications of their decisions did not increase over time and 92 percent of participants would make the same choice today.
Researchers at Mayo Clinic, Rochester, Minn., surveyed women diagnosed with unilateral breast cancer who had undergone a contralateral prophylactic mastectomy in their facility between 1960 and 1993. An initial questionnaire was completed an average of 10 years after the elective mastectomy. This week, researchers reported results of a follow-up survey completed by 269 of these women an average of 20 years after their surgeries.
According to researcher Judy C. Boughey, MD, “We found remarkable stability across the two surveys on participant satisfaction. In fact, when women changed their opinions, they generally indicated greater, rather than less, comfort with their choice.”
Patients who already have had breast cancer are at slightly greater risk for a second cancer than the general population. Further, many women who chose prophylactic mastectomies have breast cancer family histories, compounding their chances of a contralateral breast cancer.
The first survey found that 86 percent of participants were satisfied 10 years after their procedures, while 90 percent indicated satisfaction after 20 years. Only six percent reported dissatisfaction with their decision, and that figure remained constant across both questionnaires. In the recent survey, 93 percent felt they made an informed decision that reflected their overall values. Almost 80 percent of these women also had breast reconstruction.
When recounting the adverse effects, patients frequently cited body appearance, sense of femininity and sexual relationships. This remained constant over time.
Patients describing the positive impact of their choice in their own words commented: “I don’t seem to worry about breast cancer now…” “By having a prophylactic mastectomy, my fears (many) were erased, not 100 percent, but close to it.” “I didn’t want to be worrying and thinking about it (cancer in the other breast)…”
Noting that prophylactic mastectomy rates have been steadily increasing, Dr. Boughey believes that knowing few women regret their decisions should help reassure those facing this difficult choice today. However, she advises all women to consider such a decision carefully and to balance the negative consequences of mastectomy with their risk of cancer recurrence and need to achieve peace-of-mind.
“Because patients in our survey showed a high degree of satisfaction doesn’t mean the choice is right for everybody,” she said. “This is a deeply personal decision. Understanding all the consequences is extremely important.”
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