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Contralateral prophylactic mastectomy: current perspectives.

Katharine Yao1, Mark Sisco2, Isabelle Bedrosian3

  • 1Division of Surgical Oncology, Department of Surgery.

International Journal of Women'S Health
|July 7, 2016
PubMed
Summary
This summary is machine-generated.

Contralateral prophylactic mastectomy (CPM) is increasingly common in young women with unilateral breast cancer, often driven by patient fears and misperceptions, not survival benefits. Further research is needed to clarify risks, benefits, and patient decision-making.

Keywords:
contralateral breast cancersurgical decision making

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Health Services Research

Background:

  • Rising trend of contralateral prophylactic mastectomy (CPM) in the US for unilateral breast cancer patients, especially those under 40.
  • Patient-driven decision-making for CPM, influenced by perceived survival benefits and overestimated contralateral breast cancer (CBC) risk.
  • Fear of recurrence significantly impacts CPM choices, despite limited evidence of survival advantage.

Purpose of the Study:

  • To analyze the trends, motivations, and outcomes associated with contralateral prophylactic mastectomy (CPM).
  • To review current evidence on CPM's impact on survival, contralateral breast cancer risk, and patient satisfaction.
  • To examine surgeon perspectives and cost-effectiveness of CPM, highlighting guideline inconsistencies.

Main Methods:

  • Review of existing studies on CPM trends, patient-reported outcomes, and surgeon perspectives.
  • Analysis of data on contralateral breast cancer (CBC) incidence and survival benefits.
  • Examination of cost-effectiveness studies and current clinical guidelines.

Main Results:

  • CPM use is increasing, particularly in young women, driven by patient misperceptions about survival and CBC risk.
  • No prospective studies demonstrate a survival benefit from CPM; CBC rates are generally low.
  • Patient satisfaction with CPM is common, but complications and reconstruction can lead to dissatisfaction.

Conclusions:

  • Current CPM trends may not align with evidence-based survival benefits.
  • There is a need for improved patient education regarding CPM risks and benefits.
  • Inconsistent guidelines and a lack of long-term data necessitate further research into CPM's psychosocial and survival impacts.