Bilateral Risk-Reducing Mastectomy With Immediate Breast Reconstruction Lowers Concerns of Breast Cancer in Women...

Women with a high-risk genetic predisposition for breast cancer are faced with the choice between bilateral risk-reducing mastectomy, often accompanied by immediate breast reconstruction, or radiological imaging surveillance. This study examined changes in mental well-being and health-related quality of life following surgery and compared outcomes with women adhering to surveillance. Additionally, surgical complications and regrets were assessed.

Patients were recruited from multiple clinical departments across Denmark and stratified into surgery or surveillance groups. Patient-reported outcomes were measured using validated questionnaires, including the BREAST-Q, at baseline and 3, 12, and 24 months post-surgery or post-baseline.

A total of 35 and 37 patients were included in the surgery and surveillance groups, respectively. Surgery significantly reduced concerns about developing breast cancer but also led to lower physical well-being. Significant between-group differences were found at all post-baseline time points for these outcomes. Surgically and conservatively treated complications occurred in 14% and 23% of patients, respectively. No patients regretted the surgery.

Risk-reducing mastectomy with immediate reconstruction effectively reduces breast cancer concerns in high-risk women in the short and long term but at the cost of reduced physical well-being and potential complications. These findings are essential for aligning preoperative expectations.