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Annals of Surgical Oncology, Vol 5, Issue 7 603-606, Copyright © 1998 by Society of Surgical Oncology

ARTICLES

Patient regrets after bilateral prophylactic mastectomy

P. I. Borgen, A. D. Hill, K. N. Tran, K. J. Van Zee, M. J. Massie, D. Payne and C. G. Biggs
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. BorgenP@mskcc.org

BACKGROUND: The discovery of a cadre of breast cancer susceptibility genes has resulted in an increase in the number of women seeking information about prophylactic breast surgery, but virtually no large-scale prospective databases exist to assist women considering prophylactic mastectomy. METHODS: The authors constructed a National Prophylactic Mastectomy Registry comprised of a volunteer population of 817 women from 43 states who have undergone prophylactic mastectomy. RESULTS: In the registry, 370 women had undergone bilateral prophylactic mastectomy. Twenty-one (5%) women expressed regrets about the procedure. The median follow-up was 14.6 years (mean 14.8 years; range 0.2-51 years). Those with regrets were subsetted into those with major (n = 10) or minor (n = 7) regrets. Regrets were more common in those women with whom discussion about prophylactic mastectomy was initiated by a physician (19/255), compared with patients who initiated the discussion themselves (2/108; P < .05). CONCLUSIONS: The overall satisfaction rate of 95% reported here may be explained by the voluntary nature of this registry. The most important factor that predicts an unfavorable outcome following bilateral prophylactic mastectomy is a physician-initiated discussion.


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