title: Living with a unilateral mastectomy defect: a utility assessment and outcomes study.
abstract: BACKGROUND
  The gold standard for the treatment of breast cancer includes mastectomy surgery. Our goal was to quantify the health state utility assessment of living with unilateral mastectomy.
  
  
  METHODS
  The visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG) were used to obtain utilities for unilateral mastectomy, monocular blindness and binocular blindness from a prospective sample of the general population and medical students.
  
  
  RESULTS
  All measures (VAS, TTO, SG) for unilateral mastectomy (0.75 SD 0.17, 0.87 SD 0.14, and 0.86 SD 0.18, respectively) of the 140 volunteers were significantly different from the corresponding scores for monocular (0.61 SD 0.18, 0.84 SD 0.17, and 0.84 SD 0.18, respectively) and binocular blindness (0.38 SD 0.17, 0.67 SD 0.24, and 0.69 SD 0.23, respectively). Age, gender, race, education, and income were not statistically significant independent predictors of utility scores.
  
  
  CONCLUSIONS
  In a sample of the general population and medical students, utility assessments for living with unilateral mastectomy were comparable with those of living with bilateral mastectomy and severe breast hypertrophy. Our sample population, if faced living with unilateral mastectomy was willing to gamble a theoretical 14% chance of death and willing to trade 4.2 years of existing life-years.
authors.affiliation: Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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: Joshua
authors.initials: J
authors.lastname: Vorstenbosch
authors.affiliation: Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Tassos
authors.initials: T
authors.lastname: Dionisopoulos
authors.affiliation: Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ahmed M S
authors.initials: AM
authors.lastname: Ibrahim
authors.affiliation: Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Tobias
authors.affiliation: Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
authors.affiliation: Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008408:Mastectomy / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology*; D063868:Patient Outcome Assessment; D057240:Patient Preference / Q000523:psychology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires