Patient regrets after bilateral prophylactic mastectomy.
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.
Borgen
P I
PI
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. BorgenP@mskcc.org
Hill
A D
AD
Tran
K N
KN
Van Zee
K J
KJ
Massie
M J
MJ
Payne
D
D
Biggs
C G
CG
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology* / Q000601:surgery; D016009:Chi-Square Distribution; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction; D012042:Registries; D014481:United States