Aesthetic outcome, patient satisfaction, and health-related quality of life in women at high risk undergoing prophylactic mastectomy and immediate breast reconstruction

Isern, A E; Tengrup, Ingrid; Loman, Niklas; Olsson, Håkan; Ringberg, Anita

doi:10.1016/j.bjps.2007.08.006

Cited by 85 publications

(68 citation statements)

References 42 publications

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“…17 Other studies have found no regrets and also no decreased QOL among women who decided to undergo RRM. 18,19 A high level of general satisfaction after prophylactic surgery was reported in some studies and women who underwent surgery reported they would do the same again. 20,21 Reproductive concerns in BRCA mutation carriers may include guilt associated with transmission of HBOC to future generations, consideration of in vitro fertilization, preimplantation genetic diagnosis (PGD) to avoid transmission to future generations, 22 and fertility preservation for those who elect RRSO prior to completing childbearing.…”

Section: Cancer Risks Associated With the Brca Mutationmentioning

confidence: 99%

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Stan

Shuster

Wick

et al. 2013

Journal of Women's Health

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Women afflicted by the hereditary breast and ovarian cancer syndrome face complex decisions regarding medical interventions aimed at reducing their risk of ovarian and breast cancer, interventions which in turn may interfere with their fertility and cause early menopause. This review addresses selected topics of importance and controversy in the management of the BRCA mutation carrier, such as psychological well-being and quality of life, breast and ovarian cancer screening, risk-reducing interventions for breast cancer and ovarian cancer, the issue of hysterectomy at the time of the risk-reducing salpingo-oophorectomy, health consequences of early surgical menopause, and safety of hormonal therapy after oophorectomy. The information presented is based on an extensive review of the literature on the selected topics and on the expertise of our multidisciplinary team.

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Section: Cancer Risks Associated With the Brca Mutationmentioning

confidence: 99%

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Stan

Shuster

Wick

et al. 2013

Journal of Women's Health

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“…Studies have shown that up to half of women who undergo RRM report a negative impact on their sexual relationship [11,12,10], a quarter to one-third report poorer body image and reduced feelings of femininity [12,10], and women are more likely to report feelings of regret related to their surgery when body image and sexual function are adversely affected by RRM [13]. Despite this, few women who undergo RRM report that they regret their surgery decision [14,15,12].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

et al. 2014

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Purpose: To prospectively investigate long-term psychosocial outcomes for women who opted for risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO).Methods: Unaffected women from high-risk breast cancer families who had completed baseline questionnaires for an existing study and subsequently underwent RRM and/or RRSO, completed measures of perceived breast and ovarian cancer risk, anxiety, depression, cancer-related anxiety, body image, sexual functioning, menopausal symptoms, use of hormone replacement therapy and decision regret three years post-surgery. Outcomes were compared to age-and risk-matched controls.Results: Participants (N=233) were 17 women who had RRM (39 controls), 38 women who had RRSO (94 controls) and 15 women who had RRM+RRSO (30 controls). Women who underwent RRM and those who underwent RRM+RRSO reported reductions in perceived breast cancer risk and perceived breast and ovarian cancer risk respectively, compared to their respective controls. RRM women reported greater reductions in cancer-related anxiety compared with both controls and RRSO women. RRSO women reported more sexual discomfort than controls and more urogenital menopausal symptoms than controls and RRM only women. No differences in general anxiety, depression or body image were observed. Regret was associated with greater reductions in body image since surgery and more sexual discomfort, although overall regret levels were low. Conclusions:Women who undergo RRM experience psychological benefits associated with reduced breast cancer risk. Although women who undergo RRSO experience some deterioration in sexual and menopausal symptoms, they do not regret their surgery decision. It is vital that women considering these procedures receive detailed information about potential psychosocial consequences.3

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“…Immediate breast reconstruction (IBR) is performed to improve body image and the remaining quality of life for women facing mastectomy [1][2][3][4]. Success can be defined as the best possible cosmetic result that does not sacrifice oncological safety [5,6].…”

Section: Introductionmentioning

confidence: 99%

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study

Giacalone

Rathat

Daurès

et al. 2010

Breast Cancer Res Treat

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Feasibility and oncological safety of postadjuvant skin-sparing mastectomy (SSM) plus immediate breast reconstruction (IBR) cannot be evaluated by randomized trials. However, comparative study could modify guidelines for the oncosurgical treatment of invasive breast cancer. Our study compared the feasibility, oncological safety and esthetic outcome of SSM plus latissimus dorsi (LD) flap IBR after chemotherapy (CT) and radiotherapy (RT) with the standard management for invasive breast cancer: mastectomy as primary treatment, adjuvant CT and RT, and LD flap delayed breast reconstruction (DBR). Twenty-six selected patients with stages IIA-IIIA breast cancer were offered post-neoadjuvant SSM plus IBR with LD flap plus implant (IBR group). Seventy-eight other patients had primary mastectomy, adjuvant CT and RT, and LD-assisted DBR (DBR group). After 4.1 years (range 1-8) of follow-up, feasibility, oncological safety, and esthetic outcome were compared. Sixteen (61%) early complications were reported for the IBR group versus 44 (56%) for the DBR group (P = 0.645). Early implant loss was 0% in IBR versus 12% in DBR. IBR had 8 (30%) late complications versus 17 (21%) for DBR (P = 0.362). Capsular contracture and reconstruction failure rates were similar. Local recurrence was 7.7% (2/26) in IBR and 6.4% (5/78) in DBR (P = 0.823). Cosmetic evaluation by independent physicians and by the patients themselves was identical in the two groups. Our concept provides a basis for offering more women the opportunity to elect for immediate reconstruction, even in the setting of radiation therapy.

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Aesthetic outcome, patient satisfaction, and health-related quality of life in women at high risk undergoing prophylactic mastectomy and immediate breast reconstruction

Cited by 85 publications

References 42 publications

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Challenging and Complex Decisions in the Management of the BRCA Mutation Carrier

Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study

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