98 percent of elective mastectomy patients would have reconstruction again, says ASPS study

Women who have breast reconstruction after an elective mastectomy are satisfied with their decision, have low complication rates and 98 percent would do it again, reports a study in July's Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). In addition, breast reconstruction after preventive mastectomy was as safe as or safer than reconstruction in women with breast cancer and had excellent cosmetic results.

"Breast cancer is a terrible diagnosis and decisions regarding treatment are never easy. This study shows that women with cancer in one breast who choose to have their other breast removed as a preventive measure are happy with their decision and a high percentage would do it again," said Scott Spear, MD, study co-author and past ASPS president. "More remarkable is the 100 percent satisfaction level, as well as the 100 percent willingness to have breast reconstruction again, for the women who chose to have both breasts removed."

The study examined 74 women who had preventive mastectomies and subsequent breast reconstruction between 2000 and 2005. Forty-seven patients had breast cancer in one breast and elected to surgically remove their other breast (unilateral prophylactic mastectomy). Twenty-seven patients did not have breast cancer, but chose to surgically remove both breasts due to a high-risk of developing breast cancer (bilateral prophylactic mastectomy). The cosmetic outcome was scored by 14 surgeons who looked at post-reconstruction photos and evaluated the result on a 1 to 4 scale (4 being an "excellent" result).

The study found that women who had a bilateral prophylactic mastectomy were 100 percent satisfied with their breast reconstruction and 100 percent of them would have the surgery again. Ninety-four percent of women who had unilateral prophylactic mastectomy were satisfied with their reconstruction and 96 percent of them would have reconstruction again.

The complication rate for reconstruction in women who had bilateral prophylactic mastectomy was 3 percent and 10 percent for those who had unilateral prophylactic mastectomy. Additionally, the study noted the cosmetic assessment for all patients was a score of 3 out of 4.

"These women look and feel the same or better and their risk of cancer has been taken off the table," said Dr. Spear. "For women who know they are at risk, this option gives them the opportunity to be active about their health and appearance rather than reactive. They can have excellent cosmetic results, low surgical risk and a high level of satisfaction with their breast reconstruction. This is empowering for women."

According to ASPS statistics, more than 57,000 breast reconstructions were performed in 2007, up 2 percent since 2006.

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