Bilateral Prophylactic Mastectomy in Swedish Women at High Risk of Breast Cancer

2011 ◽  
Vol 253 (6) ◽  
pp. 1147-1154 ◽  
Author(s):  
Brita Arver ◽  
Karin Isaksson ◽  
Hans Atterhem ◽  
Annika Baan ◽  
Leif Bergkvist ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Prophylactic Mastectomy ◽  
Bilateral Prophylactic Mastectomy

Patient characteristics associated with the decision to undergo bilateral prophylactic mastectomy for lobular carcinoma in situ.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 148-148 ◽  
Author(s):  
S. Muhsen ◽  
M. J. Junqueira ◽  
A. Park ◽  
J. S. Sung ◽  
S. Patil ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
High Risk ◽  
Carcinoma In Situ ◽  
Prophylactic Mastectomy ◽  
Lobular Carcinoma ◽  
Lobular Carcinoma In Situ ◽  
Bilateral Prophylactic Mastectomy ◽  
Increased Risk

148 Background: Women at increased risk for breast cancer due to a diagnosis of lobular carcinoma in situ (LCIS) have three management options: high risk surveillance +/- chemoprevention (CP) or bilateral prophylactic mastectomy (BPM). Among a large cohort of women with LCIS, we previously reported there were no differences between women choosing CP compared to those choosing surveillance alone. The purpose of this study was to identify patient factors associated with the decision to pursue BPM for LCIS. Methods: We reviewed our prospectively maintained LCIS database to identify women choosing BPM (1995-2009). Comparisons were made between patients who chose BPM versus those who chose high risk surveillance +/- CP. Results: Among 995 pts with LCIS, 795 (80%) chose surveillance alone, 149 (15%) chose CP and 51 (5%) chose BPM. Compared to patients electing surveillance +/- CP patients who pursued BPM were younger at age of LCIS diagnosis (48 vs. 52 yrs, p < 0.001), more likely to have bilateral biopsies with LCIS (14% vs. 3%, p = 0.002) and more likely to be premenopausal (82% vs. 57%, p < 0.001). Patients choosing BPM were also more likely to have additional risk factors for breast cancer including: stronger family histories and extremely dense breasts (Table). Occult breast cancer was found in 4 (8%) BPM patients. At a median follow-up of 54 months (range 0-190 mos), 120/944 (13%) patients in the surveillance +/- CP group developed breast cancer. Conclusions: High-risk surveillance alone is the preferred management option for women with LCIS at our institution. Patients electing BPM are younger and more likely to have other associated risk factors for developing breast cancer. Further research to define how the increased risk imparted by LCIS is augmented by these factors may allow for better risk stratification and more informed discussions with patients. [Table: see text]

Psychological Reactions, Quality of Life, and Body Image After Bilateral Prophylactic Mastectomy in Women At High Risk for Breast Cancer: A Prospective 1-Year Follow-Up Study

2008 ◽  
Vol 26 (24) ◽  
pp. 3943-3949 ◽  
Author(s):  
Yvonne Brandberg ◽  
Kerstin Sandelin ◽  
Staffan Erikson ◽  
Göran Jurell ◽  
Annelie Liljegren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Body Image ◽  
Prophylactic Mastectomy ◽  
Sexual Pleasure ◽  
Bilateral Prophylactic Mastectomy ◽  
Anxiety Depression ◽  
The Impact ◽  
Over Time

Purpose To prospectively evaluate body image, sexuality, emotional reactions (anxiety, depression), and quality of life in a sample of women having increased risk for breast cancer before and 6 months and 1 year after bilateral prophylactic mastectomy (BPM), and to compare preoperative expectations of the operation with postoperative reactions concerning the impact on six areas of the women's lives. Patients and Methods A total of 90 of 98 consecutive women who underwent BPM during October 1997 to December 2005 were included. Data were collected by self-administered questionnaires (eg, Hospital Anxiety and Depression scale, Swedish Short Term-36 Health Survey, Body Image Scale, Sexual Activity Questionnaire) before the operation (n = 81), and 6 (n = 71) and 12 months (n = 65) after BPM. Results Anxiety decreased over time (P = .0004). No corresponding difference was found for depression. No differences in health-related quality of life over time were found, with one exception. A substantial proportion of the women reported problems with body image 1 year after BPM (eg, self consciousness, 48%; feeling less sexually attractive, 48%; and dissatisfaction with the scars, 44%). Sexual pleasure was rated lower 1-year post-BPM as compared with before operation (P = .005), but no differences over time in habit, discomfort, or activity were found. Conclusion No negative effects on anxiety, depression, and quality of life were found. Anxiety and social activities improved. Negative impact on sexuality and body image was reported.

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