An objective assessment of the perceived quality of life of living with bilateral mastectomy defect

BackgroundMastectomy is a common treatment for breast cancer. We set out to quantify the health state utility assessment of living with bilateral mastectomy using previously described validated methods.MethodsUtility assessments using visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG) were used to obtain utilities for mastectomy, monocular blindness and binocular blindness from a prospective sample of the general population and medical students.ResultsAll measures (VAS, TTO, SG) for mastectomy (0.70 ± 0.18, 0.85 ± 0.16, and 0.86 ± 0.17, respectively) of the 120 volunteers were significantly different (p < 0.0001) from the corresponding scores for binocular blindness (0.38 ± 0.17, 0.67 ± 0.24, and 0.69 ± 0.23, respectively). Utility scores for mastectomy were not statistically different (p > 0.05) when compared to those for monocular blindness (0.67 ± 0.13, 0.86 ± 0.15, and 0.86 ± 0.15, respectively). Age, gender, race, and income were not statistically significant independent predictors of utility scores. Medical education was associated with statistically significant higher SG compared to general population (0.90 ± 0.11 versus 0.84 ± 0.19; p < 0.05).ConclusionIn a sample of the general population and medical students, utility assessments for living with bilateral mastectomy were comparable with those of living with the loss of sight from one eye. Our sample population, if faced with living with bilateral mastectomy, would consent to undergo a procedure such as breast reconstruction with a theoretical 14 percent chance of mortality and be willing to trade 5.4 years of existing life-years for such a procedure.