Abstract
Background: The discovery of a cadre of breast cancer susceptibility genes has resulted in an increase in the number of women seeking information about prophylactic breast surgery, but virtually no large-scale prospective databases exist to assist women considering prophylactic mastectomy.
Methods: The authors constructed a National Prophylactic Mastectomy Registry comprised of a volunteer population of 817 women from 43 states who have undergone prophylactic mastectomy.
Results: In the registry, 370 women had undergone bilateral prophylactic mastectomy. Twenty-one (5%) women expressed regrets about the procedure. The median follow-up was 14.6 years (mean 14.8 years; range 0.2–51 years). Those with regrets were subsetted into those with major (n=10) or minor (n=7) regrets. Regrets were more common in those women with whom discussion about prophylactic mastectomy was initiated by a physician (19/255), compared with patients who initiated the discussion themselves (2/108;P<.05).
Conclusions: The overall satisfaction rate of 95% reported here may be explained by the voluntary nature of this registry. The most important factor that predicts an unfavorable outcome following bilateral prophylactic mastectomy is a physician-initiated discussion.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Easton DF, Ford D, Bishop DT, Breast Cancer Linkage Consortium. Breast and ovarian cancer incidence in BRCA1-mutation carriers.Am J Hum Genet 1995;56:265–71.
Ford D, Easton DF, Peto J. Estimates of the gene frequency of BRCA1 and its contribution to breast and ovarian cancer incidence.Am J Hum Genet 1995;57:1457–62.
Ford D, Easton DF, Bishop DT, Narod SA, Goldgar DE. Risk of cancer in BRCA-1 mutation carriers.Lancet 1994;343:692–5.
Struewing JP, Hartge P, Wacholder S. The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews.N Engl J Med 1997;336:1401–8.
Whittemore AS, Gong G, Itnyre J. Prevalence and contribution of BRCA1 mutations in breast cancer and ovarian cancer: results from three US population based case control studies of ovarian cancer.Am J Hum Genet 1997;60:496–504.
Greenwald P, Nasca PC, Lawrence CE. Estimated effect of breast self examination and routine physician examinations on breast cancer mortality.N Engl J Med 1978;299:271–3.
Kerlikowske K, Grady D, Rubin SM, Sandrock C, Ernster VL. Efficacy of screening mammography: a meta-analysis.JAMA 1995;273:149–54.
Bourne TH, Whitehead MI, Campbell S, Royston P, Bhan V, Collins WP. Ultrasound screening for familial ovarian cancer.Gynecol Oncol 1991;43:92–7.
Lerman C, Narod SA, Schulman K. BRCA1 testing in families with hereditary breast-ovarian cancer: a prospective study of patient decision making and outcomes.JAMA 1996;275:1885–92.
Hoskins KF, Stopfer JE, Calzone KA. Assessment and counseling for women with a family history of breast cancer: a guide for clinicians.JAMA 1995;273:577–85.
Gross TP, Schlesselman JJ. The estimated effect of oral contraceptive use on the cumulative risk of ephithelial ovarian cancer. Obstet Gynecol 1994;83:419–24.
Kosary CL, Ries LAG, Miller BA, Hankey BF, Harras A, Edwards BK, eds.SEER Cancer Statistics Review, 1973–1992: Tables and Graphs. Bethesda, MD: National Cancer Institute; 1995 (NIH publication no. 96-2789).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Borgen, P.I., Hill, A.D.K., Tran, K.N. et al. Patient regrets after bilateral prophylactic mastectomy. Annals of Surgical Oncology 5, 603–606 (1998). https://doi.org/10.1007/BF02303829
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02303829