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Financial toxicity and contralateral prophylactic mastectomy: an analysis using propensity score methods.

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Contralateral prophylactic mastectomy (CPM) did not increase financial toxicity in breast cancer patients. While associated with more minor complications, CPM improved psychosocial well-being.

Keywords:
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Area of Science:

  • Oncology
  • Health Economics
  • Surgical Outcomes

Background:

  • Contralateral prophylactic mastectomy (CPM) is increasingly common in average-risk breast cancer patients.
  • Evidence for survival benefit in average-risk populations is lacking.
  • Healthcare cost awareness necessitates evaluating the financial impact of such procedures.

Purpose of the Study:

  • To assess the impact of CPM on financial toxicity in breast cancer patients.
  • To determine if CPM influences patient-reported financial strain.
  • To evaluate secondary outcomes including quality of life and complications.

Main Methods:

  • Propensity-matched analysis of 104 female breast cancer patients undergoing unilateral mastectomy (UM) with or without CPM.
  • Exclusion of patients with genetic predisposition or bilateral cancer.
  • Financial toxicity assessed using the Comprehensive Score for financial Toxicity (COST); secondary outcomes via Breast Q and SF12.

Main Results:

  • CPM was not associated with increased financial toxicity (COST scores comparable).
  • CPM group had significantly higher minor complication rates (31% vs 8%).
  • CPM was linked to improved psychosocial well-being scores (Breast Q).

Conclusions:

  • CPM does not elevate financial toxicity in breast cancer patients.
  • CPM is associated with higher minor complications but improved psychosocial well-being.
  • Further prospective research is needed to understand CPM's long-term financial impact.