Originally published as JCO Early Release 10.1200/JCO.2006.07.3890 on December 11 2006

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Quality of Life After Contralateral Prophylactic Mastectomy in Newly Diagnosed High-Risk Breast Cancer Patients Who Underwent BRCA1/2 Gene Testing

Kenneth P. Tercyak, Beth N. Peshkin, Barbara M. Brogan, Tiffani DeMarco, Marie F. Pennanen, Shawna C. Willey, Colette M. Magnant, Sarah Rogers, Claudine Isaacs, Marc D. Schwartz

From the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC

Address reprint requests to Marc D. Schwartz, PhD, Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven St NW, Ste 4100, Washington, DC 20007-2401; e-mail: schwartm{at}georgetown.edu

PURPOSE: Recent studies indicate that high-risk breast cancer patients (ie, women who carry mutations in BRCA1/2 genes) who opt for contralateral prophylactic mastectomy (CPM) have a substantially reduced risk of developing contralateral breast cancer. However, the immediate and long-term impact of this decision on women's quality of life and psychosocial functioning is largely unknown. In this study, we compared the impact of BRCA1/2 genetic test result and CPM on these outcomes among newly diagnosed breast cancer patients who opted for CPM at the time of their definitive surgical treatment versus patients who did not.

PATIENTS AND METHODS: Participants were 149 high-risk women who underwent genetic counseling and testing for alterations in the BRCA1/2 genes. We measured self-reported quality of life, cancer-specific distress, and genetic testing–specific distress using standardized instruments before receipt of genetic test results and again 1 and 12 months later.

RESULTS: Compared with patients who chose breast conservation or unilateral mastectomy, those who chose mastectomy of the affected breast and CPM of the unaffected breast did not report diminished quality of life or elevated distress.

CONCLUSION: With respect to quality of life and distress, patients who choose CPM fare as well as those who do not in the first year after surgery.

published online ahead of print at www.jco.org on December 11, 2006.

Supported by National Institutes of Health Grants No. R01CA074861 (M.D.S.) and K07CA091831 (manuscript preparation; K.P.T.).

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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