Quality‐of‐life after risk‐reducing mastectomy in women with increased risk of breast cancer: A longitudinal study

Risk-reducing mastectomy substantially reduces breast cancer risk in women at increased genetic or familial risk; however, it may have an impact on quality-of-life. The aim of this longitudinal study was to analyze differences in quality-of-life over time in women at increased risk of breast cancer who underwent risk-reducing mastectomy. A total of 55 cisgender women at increased risk of breast cancer, due to BRCA1/2 pathogenic variants or a significant family history, participated in the study. Some of them had a prior diagnosis of breast cancer. Quality-of-life was assessed using EORTC Quality-of-Life Questionnaire Core 30 (QLQ-C30) and the Breast Cancer-Specific Module (BR23). Assessments were conducted 15-30 days immediately before and 15-30 days immediately after the risk-reducing mastectomy, and at long-term follow-up. The follow-up assessment ranged from 1 to 15 years post-surgery (mean = 5.24 years). Changes over time were analyzed using repeated measures General Linear Models (GLM). Results indicated decreases in functional scales of quality-of-life and worsening of symptom scales following the risk-reducing mastectomy. However, quality-of-life scores returned to baseline levels at long-term follow-up. Worries regarding future perspective decreased following surgery and continued to improve over time. Although risk-reducing mastectomy was associated with short-term deterioration in selected domains, findings indicate recovery and long-term stabilization of quality-of-life. Additionally, risk-reducing mastectomy appears to alleviate future-oriented cancer concerns. This longitudinal evidence strengthens the basis for anticipatory guidance in genetic counseling and supports more balanced, evidence-informed decision-making.