Centre for Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
Academic Unit of Surgical Oncology, Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK.
Psychooncology. 2018 Jan;27(1):43-52. doi: 10.1002/pon.4448. Epub 2017 May 31.
For women who have been diagnosed with unilateral breast cancer, there is an increasing trend for them to request removal of the contralateral healthy breast, the so-called contralateral risk reducing mastectomy (CRRM). The current literature is only just beginning to identify patient-reported reasons for undergoing CRRM and associated patient-reported outcomes. It is also unclear whether women at moderate/high risk of developing a subsequent primary contralateral breast cancer report similar outcomes to those considered to be at low/average risk. This lack of knowledge provides the rationale for this review.
A rapid review methodology was undertaken to identify and explore the published research literature focused on the longer term (>5 y) psychosocial impacts on women who undergo CRRM.
Fifteen studies were identified. No UK studies were identified. High satisfaction and psychosocial well-being were consistently reported across all studies. Reducing the risk of a subsequent contralateral breast cancer and therefore reducing cancer-related anxiety, and satisfaction with cosmesis, were key themes running across all studies explaining satisfaction. Dissatisfaction was associated with adverse effects such as poor cosmesis, body image changes, femininity, sexual relationships, reoperations for acute and longer term complications, and reconstructive problems.
Satisfaction and psychological well-being following CRRM was consistently high across all studies. However, the findings suggest women need to be more fully informed of the risks and benefits of CRRM and/or immediate/delayed reconstruction to support informed decision making.
对于已被诊断出单侧乳腺癌的女性，她们越来越倾向于要求切除另一侧健康的乳房，即所谓的对侧降低风险乳房切除术（CRRM）。目前的文献才刚刚开始确定接受 CRRM 的患者报告的原因和相关的患者报告结果。此外，尚不清楚中/高风险发生随后对侧原发性乳腺癌的女性是否报告与被认为低/平均风险的女性相似的结果。这方面知识的缺乏为本次综述提供了依据。
采用快速综述方法，以确定和探讨已发表的专注于 CRRM 后长期（>5 年）心理社会影响的研究文献。
确定了 15 项研究。未发现英国的研究。所有研究均一致报告了较高的满意度和心理社会幸福感。降低发生后续对侧乳腺癌的风险，从而降低与癌症相关的焦虑，并对美容效果感到满意，是贯穿所有研究解释满意度的关键主题。不满与美容效果差、身体形象改变、女性气质、性关系、急性和长期并发症的再手术以及重建问题等不良影响有关。
所有研究均一致报告 CRRM 后的满意度和心理幸福感较高。然而，研究结果表明，需要更全面地告知女性 CRRM 以及（立即/延迟）重建的风险和益处，以支持知情决策。
