Portschy Pamela R, Abbott Andrea M, Burke Erin E, Nzara Rumbidzayi, Marmor Schelomo, Kuntz Karen M, Tuttle Todd M
Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Department of Surgical Oncology, Moffitt Cancer Center, Tampa, USA.
Ann Surg Oncol. 2015 Nov;22(12):3846-52. doi: 10.1245/s10434-015-4442-2. Epub 2015 Mar 12.
An increasing proportion of breast cancer patients undergo contralateral prophylactic mastectomy (CPM) to reduce their risk of contralateral breast cancer (CBC). Our goal was to evaluate CBC risk perception changes over time among breast cancer patients.
We conducted a prospective, longitudinal study of women with newly diagnosed unilateral breast cancer. Patients completed a survey before and approximately 2 years after treatment. Survey questions used open-ended responses or 5-point Likert scale scoring (e.g., 5 = very likely, 1 = not at all likely).
A total of 74 women completed the presurgical treatment survey, and 43 completed the postsurgical treatment survey. Baseline characteristics were not significantly different between responders and nonresponders of the follow-up survey. The mean estimated 10-year risk of CBC was 35.7 % on the presurgical treatment survey and 13.8 % on the postsurgical treatment survey (p < 0.001). The perceived risks of developing cancer in the same breast and elsewhere in the body significantly decreased between surveys. Both CPM and non-CPM (breast-conserving surgery or unilateral mastectomy) patients' perceived risk of CBC significantly decreased from pre- to postsurgical treatment surveys. Compared with non-CPM patients, CPM patients had a significantly lower perceived 10-year risk of CBC (5.8 vs. 17.3 %, p = 0.046) on postsurgical treatment surveys.
The perceived risk of CBC significantly attenuated over time for both CPM and non-CPM patients. These data emphasize the importance of early physician counseling and improvement in patient education to provide women with accurate risk information before they make surgical treatment decisions.
越来越多的乳腺癌患者接受对侧预防性乳房切除术（CPM）以降低对侧乳腺癌（CBC）风险。我们的目标是评估乳腺癌患者对CBC风险认知随时间的变化。
我们对新诊断为单侧乳腺癌的女性进行了一项前瞻性纵向研究。患者在治疗前和治疗后约2年完成一项调查。调查问题采用开放式回答或5点李克特量表评分（例如，5 = 非常可能，1 = 完全不可能）。
共有74名女性完成了术前治疗调查，43名完成了术后治疗调查。随访调查的应答者和非应答者的基线特征无显著差异。术前治疗调查中CBC的平均估计10年风险为35.7%，术后治疗调查中为13.8%（p < 0.001）。两次调查之间，患同侧乳腺癌和身体其他部位癌症的感知风险显著降低。CPM患者和非CPM患者（保乳手术或单侧乳房切除术）术后治疗调查中对CBC的感知风险均较术前显著降低。与非CPM患者相比，CPM患者术后治疗调查中对CBC的感知10年风险显著更低（5.8%对17.3%，p = 0.046）。
CPM患者和非CPM患者对CBC的感知风险均随时间显著降低。这些数据强调了早期医生咨询和改善患者教育的重要性，以便在女性做出手术治疗决策前为其提供准确的风险信息。
