Women with newly diagnosed breast cancer who considered contralateral prophylactic mastectomy were more likely to worry about cancer recurrence and were less knowledgeable about breast cancer compared with women who did not consider the procedure, according to study results presented at the Breast Cancer Symposium.
“The rate of contralateral prophylactic mastectomy among women with breast cancer in one breast has increased over the past decade,” Katharine Yao, MD, director of the breast surgical program at NorthShore University HeathSystem in Evanston, Ill., and clinical associate professor of surgery at Pritzker School of Medicine at University of Chicago, said during a press conference. “Most survey studies on this topic have surveyed patients in a retrospective fashion, sometimes years after they have undergone the procedure. Few studies have examined how many women think about surgery choices prior to even being diagnosed or prior to undergoing surgery, and what factors influence women to consider undergoing contralateral prophylactic mastectomy.”
Yao and colleagues evaluated survey data from 150 women with newly diagnosed breast cancer before they underwent lumpectomy, unilateral mastectomy or contralateral prophylactic mastectomy.
Thirty-eight percent of women indicated they had considered their surgery options before they were diagnosed with breast cancer.
During the decision-making process after diagnosis, 83 women (58%) considered contralateral prophylactic mastectomy, whereas 35 women (24.6%) did not want or consider the procedure. Another 11.3% of women knew about the procedure but did not think it was an option for them, and 5.6% were not familiar with the procedure.
Age, race, stage of disease and family history were comparable between patients who did and did not consider undergoing contralateral prophylactic mastectomy.
Women who considered contralateral prophylactic mastectomy were more likely than those who did not want or did not consider it to incorrectly believe the procedure would reduce the risk for cancer recurrence (68% vs. 47%).
A greater proportion of women considering contralateral prophylactic mastectomy thought they had a higher-than-average breast cancer risk (24% vs. 14%), and they also were more likely to report worrying very much or extremely about getting cancer elsewhere in their bodies (43% vs. 11%).
After the decision-making process, most women (59%) opted to undergo lumpectomy and 32% chose unilateral mastectomy. Nine percent of women overall — and 16% of those who considered the procedure — chose contralateral prophylactic mastectomy.
“There is so much information about breast cancer that it’s easy for patients to get overwhelmed,” Yao said in a press release. “As doctors, we have to be aware of each patient’s knowledge level and the concerns and worries he or she have. And we need to do a better job of educating patients that the risk of developing contralateral breast cancer is actually low and that breast cancer can come back in other parts of their body no matter what type of surgery they have.”
For more information:
Yao K. Abstract #71. Scheduled for presentation at: Breast Cancer Symposium; Sept. 4-6, 2014; San Francisco.
Disclosure: The researchers report no relevant financial disclosures. The study was supported by the Breast and Ovarian Research Pilot Award, funded by the Auxiliary of Evanston and Glenbrook Hospitals at NorthShore.