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Updated: May 24, 2026

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Contralateral prophylactic mastectomy: clinical and pathological features from a prospective database.

Parul N Barry1, Robert R Johnson, Matthew M Harkenrider

  • 1Departments of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, KY 40202, USA.

The American Journal of the Medical Sciences
|March 8, 2012
PubMed
Summary

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Contralateral prophylactic mastectomy (CPM) is increasingly chosen for personal reasons. This study found that fewer than 5% of patients undergoing CPM had underlying pathology in the contralateral breast, questioning its clinical utility for detecting occult cancers.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Increasing patient preference for contralateral prophylactic mastectomy (CPM) without clear clinical indications.
  • National trends show a rise in elective bilateral mastectomies.

Purpose of the Study:

  • To evaluate the incidence of occult contralateral pathology in patients undergoing CPM.
  • To identify predictive factors for occult contralateral disease in women opting for CPM.

Main Methods:

  • Retrospective review of 107 patients who underwent CPM between 2003-2009.
  • Analysis of patient demographics, tumor characteristics, and contralateral breast pathology.
  • Bivariate statistical analysis to identify predictive factors.

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Last Updated: May 24, 2026

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Main Results:

  • Only 5 "significant" occult pathologies were detected in the prophylactically removed contralateral breasts (2 DCIS, 2 LCIS, 1 invasive mucinous carcinoma).
  • No clinical or pathological factors were found to predict the presence of occult contralateral pathology.
  • The incidence of contralateral pathology was less than 5%.

Conclusions:

  • CPM for elective reasons rarely reveals significant contralateral breast pathology.
  • Current clinical and pathological factors do not predict occult contralateral disease in patients undergoing CPM.
  • The clinical utility of CPM for detecting synchronous occult contralateral primaries is questionable.