title: Increasing incidence of bilateral mastectomies: the patient perspective.
abstract: BACKGROUND
  Numerous studies have reported increasing rates of contralateral prophylactic mastectomies (CPMs). Understanding patient rationale for the surgical choice may provide insight into this trend.
  
  
  METHODS
  A questionnaire was mailed to 350 mastectomy patients identified from a community health system tumor registry.
  
  
  RESULTS
  Two hundred fifty questionnaires were received; of these, 237 had undergone mastectomy. Fifty-two percent had unilateral mastectomy (UM), and 43% had bilateral mastectomies (BMs) (6% for bilateral disease). Women younger than 60 years of age were more likely to choose BM (P = .0046). Those who had CPM were significantly more likely to make the same surgical decision (P < .0001). Reconstruction was performed in 52%, with BM patients more likely to undergo reconstruction (P = .009). Twenty-three (19%) needed unanticipated reoperation for reconstruction complications. CPM had equivalent rates of unanticipated surgery versus UM (P = .64).
  
  
  CONCLUSIONS
  Patients choosing BMs are younger, have equivalent rates of reoperation because of reconstruction complications, and are significantly more satisfied with their decision than those who chose UM.
authors.affiliation: Department of Surgery, Oregon Health and Science University, Portland, OR 97239, USA. hane@ohsu.edu
authors.forename: Esther
authors.initials: E
authors.lastname: Han
authors.forename: Nathalie
authors.initials: N
authors.lastname: Johnson
authors.forename: Margaret
authors.initials: M
authors.lastname: Glissmeyer
authors.forename: Terry
authors.initials: T
authors.lastname: Wagie
authors.forename: Bethany
authors.initials: B
authors.lastname: Carey
authors.forename: Tammy
authors.initials: T
authors.lastname: DelaMelena
authors.forename: Joanne
authors.initials: J
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008408:Mastectomy / Q000639:trends*; D008875:Middle Aged; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult