title: Satisfaction after contralateral prophylactic mastectomy: the significance of mastectomy type, reconstructive complications, and body appearance.
abstract: OBJECTIVE
  Contralateral prophylactic mastectomy (CPM) is one option for reducing the risk of a second breast cancer in women with a personal and family history of breast cancer. Few data are available regarding satisfaction, psychological, and social function after CPM. The purpose of this research is to evaluate women's long-term satisfaction with CPM, factors influencing satisfaction, and psychological and social function after CPM.
  
  
  METHODS
  This was a descriptive study of all women with a family history of breast cancer, known to be alive, who elected CPM at Mayo Clinic (Rochester, MN) between 1960 and 1993 (n = 621). Ninety-four percent of the women (n = 583) completed a study-specific questionnaire.
  
  
  RESULTS
  A mean of 10.3 years after the procedure, the majority of women (83%) were satisfied with their CPM. A smaller number were neutral (8%) or dissatisfied (9%). Women who had a subcutaneous mastectomy had more problems with reconstruction, and fewer of these women were satisfied than women with simple mastectomy. Decreased satisfaction with CPM was associated with decreased satisfaction with appearance, complications with reconstruction, reconstruction after CPM, and increased level of stress in life. The majority of women experienced no change or favorable effects in self-esteem (83%), level of stress in life (83%), and emotional stability (88%). Satisfaction with body appearance, feelings of femininity, and sexual relationships were the most adversely affected with 33%, 26%, and 23% of the women responding negatively.
  
  
  CONCLUSIONS
  Although most women are satisfied with CPM, each woman should weigh the benefits alongside the potential adverse effects.
authors.affiliation: Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA. frost.marlene@mayo.edu
authors.forename: Marlene H
authors.initials: MH
authors.lastname: Frost
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Slezak
authors.forename: Nho V
authors.initials: NV
authors.lastname: Tran
authors.forename: Constance I
authors.initials: CI
authors.lastname: Williams
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Johnson
authors.forename: John E
authors.initials: JE
authors.lastname: Woods
authors.forename: Paul M
authors.initials: PM
authors.lastname: Petty
authors.forename: John H
authors.initials: JH
authors.lastname: Donohue
authors.forename: Clive S
authors.initials: CS
authors.lastname: Grant
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sellers
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Hartmann
mesh_terms: D000223:Adaptation, Psychological; D001828:Body Image; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures; D012919:Social Behavior