Patient-Reported Outcomes After Choice for Contralateral Prophylactic Mastectomy

被引:63
作者
Hwang, E. Shelley [1 ,2 ]
Locklear, Tracie D. [1 ,2 ]
Rushing, Christel N. [1 ,2 ]
Samsa, Greg [1 ,2 ]
Abernethy, Amy P. [1 ,2 ]
Hyslop, Terry [1 ,2 ]
Atisha, Dunya M. [3 ]
机构
[1] Duke Univ, Durham, NC 27710 USA
[2] Duke Canc Inst, Durham, NC USA
[3] Univ S Florida, Tampa, FL USA
关键词
20-YEAR FOLLOW-UP; CANCER DATA-BASE; BREAST-CANCER; SATISFACTION; TRENDS; RECONSTRUCTION; SURGERY; RATES; WOMEN;
D O I
10.1200/JCO.2015.61.5427
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose The rate of contralateral prophylactic mastectomies (CPMs) continues to rise, although there is little evidence to support improvement in quality of life (QOL) with CPM. We sought to ascertain whether patient-reported outcomes and, more specifically, QOL differed according to receipt of CPM. Methods Volunteers recruited from the Army of Women with a history of breast cancer surgery took an electronically administered survey, which included the BREAST-Q, a well-validated breast surgery outcomes patient-reporting tool, and demographic and treatment-related questions. Descriptive statistics, hypothesis testing, and regression analysis were used to evaluate the association of CPM with four BREAST-Q QOL domains. Results A total of 7,619 women completed questionnaires; of those eligible, 3,977 had a mastectomy and 1,598 reported receipt of CPM. Women undergoing CPM were younger than those who did not choose CPM. On unadjusted analysis, mean breast satisfaction was higher in the CPM group (60.4 v 57.9, P < .001) and mean physical well-being was lower in the CPM group (74.6 v 76.6, P < .001). On multivariable analysis, the CPM group continued to report higher breast satisfaction (P = .046) and psychosocial well-being (P = .017), but no difference was reported in the no-CPM group in the other QOL domains. Conclusion Choice for CPM was associated with an improvement in breast satisfaction and psychosocial wellbeing. However, the magnitude of the effect may be too small to be clinically meaningful. Such patient-reported outcomes data are important to consider when counseling women contemplating CPM as part of their breast cancer treatment. (C) 2016 by American Society of Clinical Oncology
引用
收藏
页码:1518 / +
页数:15
相关论文
共 31 条
[21]   Development of a New Patient-Reported Outcome Measure for Breast Surgery: The BREAST-Q [J].
Pusic, Andrea L. ;
Klassen, Anne F. ;
Scott, Amie M. ;
Klok, Jennifer A. ;
Cordeiro, Peter G. ;
Cano, Stefan J. .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2009, 124 (02) :345-353
[22]  
Rasch G, 1960, PROBABILISTIC MODELS
[23]   Perceptions, Knowledge, and Satisfaction With Contralateral Prophylactic Mastectomy Among Young Women With Breast Cancer [J].
Rosenberg, Shoshana M. ;
Tracy, Michaela S. ;
Meyer, Meghan E. ;
Sepucha, Karen ;
Gelber, Shari ;
Hirshfield-Bartek, Judi ;
Troyan, Susan ;
Morrow, Monica ;
Schapira, Lidia ;
Come, Steven E. ;
Winer, Eric P. ;
Partridge, Ann H. .
ANNALS OF INTERNAL MEDICINE, 2013, 159 (06) :373-+
[24]   Increasing trend of contralateral prophylactic mastectomy: What are the factors behind this phenomenon? [J].
Soran, Atilla ;
Polat, Ayfer Kamali ;
Johnson, Ronald ;
McGuire, Kandace P. .
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND, 2014, 12 (06) :316-322
[25]   An evaluation of patient reported outcomes following breast reconstruction utilizing Breast Q [J].
Sugrue, Ryan ;
MacGregor, Geraldine ;
Sugrue, Michael ;
Curran, Sharon ;
Murphy, Laura .
BREAST, 2013, 22 (02) :158-161
[26]   Increasing use of contralateral prophylactic mastectomy for breast cancer patients: A trend toward more aggressive surgical treatment [J].
Tuttle, Todd M. ;
Habermann, Elizabeth B. ;
Grund, Erin H. ;
Morris, Todd J. ;
Virnig, Beth A. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (33) :5203-5209
[27]   Increasing Rates of Contralateral Prophylactic Mastectomy Among Patients With Ductal Carcinoma In Situ [J].
Tuttle, Todd M. ;
Jarosek, Stephanie ;
Habermann, Elizabeth B. ;
Arrington, Amanda ;
Abraham, Anasooya ;
Morris, Todd J. ;
Virnig, Beth A. .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (09) :1362-1367
[28]   Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer [J].
Veronesi, U ;
Cascinelli, N ;
Mariani, L ;
Greco, M ;
Saccozzi, R ;
Luini, A ;
Aguilar, M ;
Marubini, E .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (16) :1227-1232
[29]   WEIGHTED LIKELIHOOD ESTIMATION OF ABILITY IN ITEM RESPONSE THEORY [J].
WARM, TA .
PSYCHOMETRIKA, 1989, 54 (03) :427-450
[30]   Contralateral prophylactic mastectomy and survival: report from the National Cancer Data Base, 1998-2002 [J].
Yao, Katharine ;
Winchester, David J. ;
Czechura, Tomasz ;
Huo, Dezheng .
BREAST CANCER RESEARCH AND TREATMENT, 2013, 142 (03) :465-476