F. Kazzazi1, R. Haggie1, P. Forouhi2, N. Kazzazi3, L. Wyld3,6, C. Malata2,4 1University Of Cambridge,Clinical School,Cambridge, CAMBRIDGESHIRE, United Kingdom 2Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust,Cambridge Breast Unit,Cambridge, CAMBRIDGESHIRE, United Kingdom 3Doncaster Royal Infirmary,Jasmine Breast Centre,Doncaster, SOUTH YORKSHIRE, United Kingdom 4Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust,Department Of Plastic And Reconstructive Surgery,Cambridge, CAMBRIDGESHIRE, United Kingdom 5Anglia Ruskin University,Postgraduate Medical Institute, Faculty Of Medical Sciences,Cambridge, CAMBRIDGESHIRE, United Kingdom 6University Of Sheffield,Sheffield, SOUTH YORKSHIRE, United Kingdom
Introduction:
Patients undergoing mastectomy and immediate breast reconstruction (IBR) for cancer may be expected to have different perceptions of long term outcomes compared with those who elect to have this operation as a risk-reducing measure. There are no reports directly comparing patient satisfaction between therapeutic and risk-reducing bilateral mastectomy and IBR. Our null hypothesis is that patients will report the same outcomes after bilateral surgery for cancer compared with risk reducing.
Methods:
Patients undergoing bilateral mastectomy and reconstruction from 2008-2014 at the Cambridge Breast Unit, were identified from a prospective register. The validated Breast-Q™ questionnaire was mailed to all following the “total Dillman method” of administering postal questionnaires. Q-SCORE software was utilised to analyse patient satisfaction and compare the two groups.
Results:
112 patients had bilateral surgery. Of the bilateral reconstructions 14.3% were therapeutic (median age = 50) and 47.3% were risk-reducing (median age = 43). 38.3% of patients fell in a combined aetiology group of risk-reducing in one breast with therapeutic contralateral mastectomy (median age = 46). The overall response rate was 58.4%. The therapeutic group had higher patient satisfaction than risk reducing group across most domains (therapeutic/ risk-reducing); breast: 68.8/68.3, outcome: 81.3/75.6, psychosocial: 77.9/75.7, sexual: 62.1/53.8, physical: 72.6/74.0 admin: 85.6/84.1. The combination group scored lowest in most domains.
Conclusion:
RRM and immediate reconstruction has been a major advance in the management of patients who may later suffer cancer. The decision to have bilateral RRM is in many patients’ minds is influenced by the availability of IBR. Our study suggests it is important to counsel these patients well because of their lower satisfaction rates however, more investigation is required to understand the lower satisfaction of the combination group.