In addition, breast reconstruction after preventive mastectomy was as safe as or safer than reconstruction in women with breast cancer and had excellent cosmetic results.
"Breast cancer is a terrible diagnosis and decisions regarding treatment are never easy. This study shows that women with cancer in one breast who choose to have their other breast removed as a preventive measure are happy with their decision and a high percentage would do it again," said Scott Spear, MD, study co-author and past ASPS president. "More remarkable is the 100 percent satisfaction level, as well as the 100 percent willingness to have breast reconstruction again, for the women who chose to have both breasts removed."
The study examined 74 women who had preventive mastectomies and subsequent breast reconstruction between 2000 and 2005. Forty-seven patients had breast cancer in one breast and elected to surgically remove their other breast (unilateral prophylactic mastectomy). Twenty-seven patients did not have breast cancer, but chose to surgically remove both breasts due to a high-risk of developing breast cancer (bilateral prophylactic mastectomy). The cosmetic outcome was scored by 14 surgeons who looked at post-reconstruction photos and evaluated the result on a 1 to 4 scale (4 being an "excellent" result).
The study found that women who had a bilateral prophylactic mastectomy were 100 percent satisfied with their breast reconstruction and 100 percent of them would have the surgery again. Ninety-four percent of women who had unilateral prophylactic mastectomy were satisfied with their reconstruction and 96 percent of them would have reconstruction again.
The complication rate for reconstruction in women who had bilateral prophylactic mastectomy was 3 percent and 10 percent for those who had unilateral prophylactic mastectomy. Additionally, the study noted the cosmetic assessment for all patients was a score of 3 out of 4.
"These women look and feel the same or better and their risk of cancer has been taken off the table," said Dr. Spear. "For women who know they are at risk, this option gives them the opportunity to be active about their health and appearance rather than reactive. They can have excellent cosmetic results, low surgical risk and a high level of satisfaction with their breast reconstruction. This is empowering for women."
According to ASPS statistics, more than 57,000 breast reconstructions were performed in 2007, up 2 percent since 2006. -American Society of Plastic Surgeons
Posted July 7th, 2008 by harminka
I would be intersested in a report that reproted how many did not ope for reconstruction along with the results for those who did and the reason for the choice they made.
More than likely this comment will not appear but I am 53 and had reconstruction and I would never do it again...
My view on this won't be popular
Bias in research -- it's really important to reocognize it when it's present.
The article suggests that all women who have mastectomies then have reconstructive surgery, but this is not true. I had a mastectomy instead of a lumpectomy because I did not want to do six weeks of radiation, five days a week.
I also chose to NOT have reconstructive surgery. This was nearly two years ago. Clearly I could have that reconstructive surgery at any time, and yet I don't. Why not? Because I am perfectly happy as I am. If I were younger (I am 62), perhaps I would have made a different choice. I also know several women who have had bilateral mastectomies without reconstruction.
It is a perfectly legitimate choice to not have reconstructive surgery. For me, I was tired of being sick. I had the mastectomy. Then I had to have my teeth pulled because they were a serious infection risk during chemotherapy. Then there was five months of chemo and nine months more while I finished Herceptin. Enough was enough to me.
A parallel article suggests that the surgeon's attitude influences whether a woman has reconstructive surgery or not, but nowhere have I seen any research that might talk to the women who have made my choice, and I can't help but wonder: are the plastic surgeons afraid that women like me will hurt their business?