Bilateral prophylactic mastectomy: Complications and subsequent procedures. C. N. West, M. B. Barton, A. I. Liu, A. M. Geiger, Cancer Research Network PROTECTS Group; Kaiser Permanente Southern California, Pasadena, CA; Harvard Pilgrim Health Care, Boston, MA Abstract: Background: Bilateral prophylactic mastectomy is highly efficacious but little is known about the complications or subsequent procedures needed to rectify complications or cosmetic problems. We therefore studied the complications and procedures occurring after bilateral prophylactic mastectomy. Methods: We used automated hospitalization and cancer registry records to identify women who underwent bilateral mastectomy without breast cancer at one of six health maintenance organizations between 1979 and 1999. Structured medical record reviews confirmed that bilateral mastectomies were done for prophylactic reasons, identified timing of initial reconstruction and ascertained complications and subsequent procedures. Results: During the study period 270 women underwent bilateral prophylactic mastectomy. Median age of women at surgery was 44 years (range 23 to 74) and the majority (90%) were Caucasian. Most women (179, 66%) had simultaneous reconstruction but 36 (13%) had delayed reconstruction and 55 (20%) had none. After bilateral prophylactic mastectomy 466 complications occurred in 171 (63%) women, with a median of two per woman (range 1 to 13). Over half (55%) required repair, including excessive scarring and implant leakage or rupture. About a third (167, 36%) were temporary, including hematoma, hemorrhage and infection. The remaining 42 (9%) complications were permanent or psychological, including lymphedema and depression. A total of 822 subsequent procedures were performed in 167 (62%) women, with a median of 4 per woman (range 1 to 22). Nearly all (766, 93%) were cosmetic in nature. Complications and subsequent procedures were less common in women with no reconstruction (chi square p=0.067 and p=<0.001 respectively) but occurred in nearly identical proportions among women with simultaneous or delayed reconstruction (chi square p=0.764 and p=0.958 respectively). Conclusions: Women undergoing bilateral prophylactic mastectomy are at risk for a range of complications and after reconstruction additional procedures may be required. Women and their physicians need to weigh these risks with the potential benefits of bilateral prophylactic mastectomy. Abstract No: 6041 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.