Perceptions of Prophylactic Mastectomy in Korea

Background Increasingly, prophylactic mastectomy has been evaluated as a treatment of breast cancer. Hereditary breast cancer now accounts for approximately 5%–10% of all cases of breast cancer, meaning that the widespread implementation of prophylactic mastectomy may significantly reduce the occurrence of breast cancer. However, prophylactic mastectomy is rarely performed in Korea. Therefore, in this study, we assessed Koreans' attitudes toward and awareness of preventive mastectomy.

Methods This was a prospective study of a cohort of patients attending outpatient clinics and their relatives. Data were collected using self-administered questionnaires assessing sex, age, educational level, knowledge of breast cancer, understanding of prophylactic mastectomy, attitudes toward prophylactic mastectomy, and reasons for choosing prophylactic mastectomy.

Results Sixty-five patients were included. Most patients (36.9%) were between 40 and 49 years of age and 58.4% were college graduates. Only six respondents (9%) understood prophylactic mastectomy, and 17 respondents (27%) stated that they would agree to undergo prophylactic mastectomy if necessary. Reasons given for refusing prophylactic mastectomy included aesthetic concerns (38%), the perception that it would not cure the disease (26%), possible surgical complications (24%), and financial cost (6%).

Conclusions In this study, most of the respondents showed a poor knowledge of prophylactic mastectomy. Ultimately, it will be necessary to establish medical guidelines for patients with a high risk of breast cancer, with the objective of providing accurate information and proper treatment at hospitals.

Keywords

Prophylactic surgical procedures - Breast neoplasms - Mastectomy

Publication History

Received: 21 July 2015

Accepted: 24 September 2015

Article published online:
20 April 2022

• References

• 1 Korean Breast Cancer Society. Breast cancer facts & figures, 2013. Seoul: Korean Breast Cancer Society; 2013
• 2 Claus EB, Schildkraut JM, Thompson WD. et al. The genetic attributable risk of breast and ovarian cancer. Cancer 1996; 77: 2318-2324
• 3 Rebbeck TR, Lynch HT, Neuhausen SL. et al. Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 2002; 346: 1616-1622
• 4 Hartmann LC, Schaid DJ, Woods JE. et al. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med 1999; 340: 77-84
• 5 Lostumbo L, Carbine NE, Wallace J. Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev 2010; (11) CD002748
• 6 See HT, Cheung YB, Yong F. et al. Acceptance of prophylactic surgery and chemoprevention of cancer in Singapore: a survey. Ann Acad Med Singapore 2005; 34: 238-242
• 7 Stefanek ME, Helzlsouer KJ, Wilcox PM. et al. Predictors of and satisfaction with bilateral prophylactic mastectomy. Prev Med 1995; 24: 412-419
• 8 Son BH, Ahn SH, Lee MH. et al. Hereditary breast cancer in Korea: a review of the literature. J Breast Cancer 2008; 11: 1-9
• 9 Schrag D, Kuntz KM, Garber JE. et al. Decision analysis: effects of prophylactic mastectomy and oophorectomy on life expectancy among women with BRCA1 or BRCA2 mutations. N Engl J Med 1997; 336: 1465-1471
• 10 Schrag D, Kuntz KM, Garber JE. et al. Life expectancy gains from cancer prevention strategies for women with breast cancer and BRCA1 or BRCA2 mutations. JAMA 2000; 283: 617-624
• 11 Scheuer L, Kauff N, Robson M. et al. Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers. J Clin Oncol 2002; 20: 1260-1268
• 12 Kim KS, Kim S, Han SA. et al. Contralateral prophylactic mastectomy and prophylactic salphingo-oophorectomy in a BRCA1-Positive breast cancer patient: a case report. J Breast Cancer 2008; 11: 218-222
• 13 Kim KS, Kim SW, Lee MH. et al. Practice patterns of surgeons for the management of hereditary breast cancer in Korea. J Breast Cancer 2008; 11: 95-101
• 14 Chenevix-Trench G, Milne RL, Antoniou AC. et al. An international initiative to identify genetic modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: the Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA). Breast Cancer Res 2007; 9: 104
• 15 Parmigiani G, Berry D, Aguilar O. Determining carrier probabilities for breast cancer-susceptibility genes BRCA1 and BRCA2. Am J Hum Genet 1998; 62: 145-158
• 16 Silva E. Genetic counseling and clinical management of newly diagnosed breast cancer patients at genetic risk for BRCA germline mutations: perspective of a surgical oncologist. Fam Cancer 2008; 7: 91-95