Patient Decision Making, Satisfaction, And Quality Of Life Following Contralateral Prophylactic Mastectomy

e19610 Background: Contralateral prophylactic mastectomy (CPM) has been associated with decreased rates of contralateral breast cancers. However, its impact on breast cancer-specific mortality is less clear. Although more women are electing CPM, there is limited data regarding decision-making factors, satisfaction and the long-term psychosocial implications of the procedure. Herein, we evaluate these factors to better understand patient contentment. Methods: Using an IRB-approved, retrospective chart review, we identified women with unilateral, non-metastatic breast cancer who underwent mastectomy. Within this group, those who elected CPM were queried using a self-administered, standard instrument questionnaire to assess decision making-factors and measure cancer-specific distress and quality of life. Results: Women treated with CPM were younger, more likely to be BRCA-positive and undergo breast reconstruction (p < .01) compared to women with unilateral mastectomy. 53% responded to the questionnaire. Median time from diagnosis to survey completion was 36 months. Demographics and patient tumor characteristics did not differ between respondents and non-respondents. 86% of patients were satisfied with CPM. Higher satisfaction scores were reported by women who were BRCA-positive, underwent reconstruction, and did not receive adjuvant chemotherapy (p < .05). 63% were depressed, which was associated with premenopausal status, age less than 40 years of age, and being within 1 year of CPM (p < .05). 43% of women reported moderate to severe psychological distress, which was higher in Latino women (p < .01) and those not receiving adjuvant radiation (p < .05). Depression was strongly associated with cancer-specific preoccupation and distress (p < .01). Satisfaction scores had a negative correlation to depression scores (.36; p < .05). Conclusions: The majority of women undergoing CPM expressed satisfaction with their decision and outcome. Although younger women were more likely to elect CPM, they were also more likely to report long-term depression. These data reinforce the necessity of a thorough patient-physician discussion regarding alternatives, outcomes, and long-term expectations. No significant financial relationships to disclose.