Patient-reported outcome of bilateral and contralateral risk-reducing mastectomy: A cross- sectional study

• Median satisfaction of patients post-mastectomy was equal to or higher than reference. • Better satisfaction in the CRRM group, likely due to the cancer diagnosis. • Most women had no regrets about the surgery, choosing it due to cancer fear and anxiety. • Procedure reduces anxiety and breast cancer incidence, but does not improve survival. • Further studies needed due to study limitations: low response rate, short follow-up. There is a lack of studies evaluating patient satisfaction after a risk-reducing mastectomy using validated instruments. The aim of this study was to evaluate patient-reported outcomes (PRO) after risk-reducing mastectomy and primary implant reconstruction. We retrospectively collected and interviewed all patients who underwent risk-reducing mastectomy and implant reconstruction at the Breast Unit of the Kepler University Hospital Linz (Austria) between 2011 and 2021. The patients were divided into two groups: The first group included patients who underwent bilateral risk-reducing mastectomy and the second group included those who underwent contralateral risk-reducing mastectomy. The results were analysed separately. A total of 114 patients with a high risk of breast cancer were selected for this study. Of these patients who met the inclusion criteria, 78 completed the questionnaire: 43 underwent a contralateral risk-reducing mastectomy (CRRM) and 35 underwent a bilateral risk-reducing mastectomy (BRRM). Both groups showed high overall satisfaction, with the CRRM group achieving a slightly better result that reached statistical significance in the domain “satisfaction with breasts” (69 vs. 58, p=0.011). More than 80% of patients would repeat this operation. The most important factor that guided patients toward a risk-reducing procedure was the fear of cancer. In our study, favorable PROs and satisfaction were observed after risk-reducing mastectomies. These results may help physicians to counsel women at high risk of breast cancer.