Hematology, Oncology, and Blood & Marrow Transplantation, UIHC, Iowa City, IA
Chang Xia , Mary C. Schroeder , Ronald Weigel , Sonia L Sugg , Alexandra Thomas
Background: There has been a marked increase in the use of contralateral prophylactic mastectomy (CPM) for women with unilateral breast cancer. Previous studies on quality of life (QoL) measures for women who have undergone CPM are mixed. Most surveys were conducted only post-operatively. This analysis reports QoL changes within the same patient before and after surgery, using a validated tool. Methods: This study includes women who were prospectively enrolled in the University of Iowa Breast Molecular Epidemiologic Resource. We included all women who had mastectomy on the affected side. Patients completed a validated QoL survey (FACT-B) which covered: overall QoL and additional cancer-specific concerns. Responses followed a five-point scale. Surveys must have been completed any time before surgery and 6-18 months after surgery. A Fixed Effects linear regression model was used to discern within-person changes in QoL measures before and after surgery. Analysis was stratified by unilateral mastectomy (UM) or CPM. Results: The study cohort included 34 women, 17 received CPM and 17 received UM. Mean age was 61.5 for women who chose UM and 50.6 for women who chose CPM (p <0.001). There were no differences in baseline QoL measures between the two groups. After surgery, both groups felt less nervous, though the change in the CPM group was greater (p<0.001). There were no other differences for the UM group in pre-post QoL measures. Women undergoing CPM did have QoL decrements (Table). Conclusions: Women who chose CPM feel less nervous after surgery. However, these women lose some sense of femininity and are more likely to experience physical post-operative sequelae. This adds to knowledge that can be used to counsel women about physical and emotional costs associated with CPM that manifest 6-18 months after surgery.
QoL: Pre to postoperative change | UM |
CPM |
||
---|---|---|---|---|
Pre-post change |
p | Pre-post Change |
p | |
I feel nervous | -1.18 | <0.001 | -1.46 | <0.001 |
I am able to feel like a woman | 0 | 1.0 | -1.18 | 0.01 |
I have certain parts of my body where I experience pain |
0.73 | 0.21 | 1.18 | 0.03 |
Movement of my arm is painful | 0.57 | 0.14 | 0.88 | 0.03 |
I have stiffness of my arm | 0.43 | 0.27 | 0.63 | 0.04 |
My arm feels numb | 0.43 | 0.60 | 1.13 | 0.07 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2019 ASCO Annual Meeting
First Author: Demetria Joy Smith-Graziani
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Yumiko Hojo
2016 ASCO Annual Meeting
First Author: Mary Chen Schroeder
2023 ASCO Annual Meeting
First Author: Jun J. Mao