title: An objective assessment of the perceived quality of life of living with bilateral mastectomy defect.
abstract: BACKGROUND
  Mastectomy is a common treatment for breast cancer. We set out to quantify the health state utility assessment of living with bilateral mastectomy using previously described validated methods.
  
  
  METHODS
  Utility assessments using visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG) were used to obtain utilities for mastectomy, monocular blindness and binocular blindness from a prospective sample of the general population and medical students.
  
  
  RESULTS
  All measures (VAS, TTO, SG) for mastectomy (0.70 ± 0.18, 0.85 ± 0.16, and 0.86 ± 0.17, respectively) of the 120 volunteers were significantly different (p < 0.0001) from the corresponding scores for binocular blindness (0.38 ± 0.17, 0.67 ± 0.24, and 0.69 ± 0.23, respectively). Utility scores for mastectomy were not statistically different (p > 0.05) when compared to those for monocular blindness (0.67 ± 0.13, 0.86 ± 0.15, and 0.86 ± 0.15, respectively). Age, gender, race, and income were not statistically significant independent predictors of utility scores. Medical education was associated with statistically significant higher SG compared to general population (0.90 ± 0.11 versus 0.84 ± 0.19; p < 0.05).
  
  
  CONCLUSIONS
  In a sample of the general population and medical students, utility assessments for living with bilateral mastectomy were comparable with those of living with the loss of sight from one eye. Our sample population, if faced with living with bilateral mastectomy, would consent to undergo a procedure such as breast reconstruction with a theoretical 14 percent chance of mortality and be willing to trade 5.4 years of existing life-years for such a procedure.
authors.affiliation: Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Hani
authors.initials: H
authors.lastname: Sinno
authors.affiliation: Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Izadpanah
authors.affiliation: Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Thibaudeau
authors.affiliation: Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Christodoulou
authors.affiliation: Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Lin
authors.affiliation: Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada. Electronic address: tassosdion@gmail.com.
authors.forename: Tassos
authors.initials: T
authors.lastname: Dionisopoulos
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D018567:Breast Neoplasms, Male; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008408:Mastectomy / Q000523:psychology*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult