Contralateral prophylactic mastectomy in breast cancer patients with a family history: a prospective 2-years follow-up study of health related quality of life, sexuality and body image.
BACKGROUND
Contralateral prophylactic mastectomy (CPM) is the most effective option to prevent the occurrence of a second breast cancer in hereditary breast cancer patients. This study aimed to prospectively evaluate health-related quality of life (HRQoL), anxiety and depression, sexuality and body image in breast cancer patients with a family history undergoing CPM with immediate breast reconstruction.


METHODS
In total, 60 of 69 eligible patients agreed to participate in the study. Four validated questionnaires were used: the SF-36, the Hospital Anxiety and Depression Scale (HAD), the Body Image Scale (BIS), and the Sexual Activity Questionnaire (SAQ). Forty-five patients (75%) responded before CPM, 49 (82%) at 6 months, and 45 (75%) at 2 years after CPM.


RESULTS
Overall, the patients showed a satisfactory HRQoL 2 years after CPM, similar to women in the general population. There were no differences in HRQoL, anxiety, depression or sexuality before and after CPM. However, more than half of the women reported at least one body image problem 2 years postoperatively.


CONCLUSIONS
No adverse effects on HRQoL, anxiety, depression or sexuality were observed. However, some aspects of body image were negatively affected after CPM. These findings could be used in preoperative counselling of breast cancer patients opting for CPM.
Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176 Stockholm, Sweden. Dmytro.Unukovych@ki.se
Dmytro
D
Unukovych
Kerstin
K
Sandelin
Annelie
A
Liljegren
Brita
B
Arver
Marie
M
Wickman
Hemming
H
Johansson
Yvonne
Y
Brandberg
D000328:Adult; D000368:Aged; D001828:Body Image; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D019529:Sexuality; D011795:Surveys and Questionnaires