Division of Chief of Breast Surgery shares findings from new study at San Antonio Breast Cancer Symposium

Laura Dominici, MD, FACS

Laura Dominici, MD, FACS, Division Chief of Breast Surgery and Medical Director of Brigham and Women’s Faulkner Breast Center at Brigham and Women’s Faulkner Hospital, recently shared the results of her latest study “Local therapy and quality of life outcomes in young women with breast cancer” at the San Antonio Breast Cancer Symposium (SABCS) both as an oral presentation and as part of the press program.

“Nationally, the rates of women having bilateral mastectomy, particularly the rates of young women having bilateral mastectomy, have skyrocketed. In fact, from 1998 to 2011, it went up ten-fold,” says Dr. Dominici. “But we also now know that the oncologic outcomes of breast cancer surgeries, which include breast conserving surgery, mastectomy and double mastectomy, are really all the same. A lot of our young women say they choose bilateral mastectomy because they want peace of mind or because they want to feel better and they think they will feel better if they choose bilateral mastectomy. We wanted to see if the reasons they give prove to be true.”

Dr. Dominici’s study examined results from the BREAST-Q questionnaire, a tool developed by Andrea Pusic, MD, MHS, FACS, FRCSC, Chief of Plastic and Reconstructive Surgery at Brigham Health, during her time at the Memorial Sloan-Kettering Cancer Center. The questionnaire was administered to 561 women who were diagnosed with breast cancer and were already enrolled in a study by Ann Partridge, MD, MPH, a medical oncologist, and Shoshana Rosenberg, PhD, an epidemiologist, both from Dana-Farber Cancer Institute.

The results of the study were striking. “We looked at different aspects of a woman’s life after her breast cancer treatment, specifically how satisfied a woman is with her breasts, how she feels physically, how she feels from a psycho-social standpoint and her sexual wellbeing,” explains Dr. Dominici of her methods. “Although there were no physical differences in quality of life among the women who have had the various surgeries, when you look at satisfaction with their breasts, psycho-social wellbeing and sexual wellbeing, those women who had mastectomy, particularly bilateral mastectomy, report negative quality of life compared to lumpectomy.”

Dr. Dominici says it was exciting to share these findings with the attendees at SABCS. “It was an academic conference, so it was a group of people who all treat breast cancer,” she says. “I was pleased by how well the project was received. People were telling me that they spend a lot of their days trying to talk patients out of mastectomy and this validates their efforts. People have been having a hard time counseling patients without information and data. Hopefully, the data that we are collecting can be helpful when it comes to informing our patients as far as long-term quality of life outcomes.”

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