Less correspondence between expectations before and cosmetic results after risk-reducing mastectomy in women who are mutation carriers: A prospective study

Purpose: The primary aim was to describe satisfaction with the cosmetic results six months and one year after risk-reducing mastectomy (RRM) with immediate breast reconstruction. Another aim was to ascertain associations between ratings on correspondence between the overall results and expectations before RRM and age, mutation carrier status, salpingo-oophorectomy (SOE) before RRM, body image, and with sexual pleasure and discomfort. Methods: 91/100 women who underwent RRM between 1997 and 2005 were included. Assessments were made six and twelve months after RRM with questionnaires regarding satisfaction with the cosmetic results, sexuality (SAQ), and body image (BIS). Results: At both assessment points, >70% of the women considered the overall results of RRM to correspond to their expectations. Over 80% were satisfied with the size of their breasts, but 49% indicated at the one-year assessment that at least one breast was too hard and 73% indicated that they had no or only minor sensitivity in the breasts. In the univariate analyses, associations between correspondence between the overall results and expectations before RRM and mutation carrier status (p = 0.039) and SOE (p = 0.025) were found, but only mutation carrier status remained in the multivariate analysis (0.037). Conclusion: The majority of the women reported that the results of RRM corresponded to their expectations, with lower levels of correspondence in mutation carriers than in non-carriers. Overall satisfaction with the cosmetic result was high, but a majority of the women were unsatisfied with the softness of the reconstructed breasts. These results can be useful when informing patients about RRM. (C) 2011 Elsevier Ltd. All rights reserved.