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Is It Worth the Risk? Contralateral Prophylactic Mastectomy With Immediate Bilateral Breast Reconstruction.

Tara M Chadab1, Jaime L Bernstein1, Andrea Lifrieri2

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Annals of Plastic Surgery
|April 9, 2021
PubMed
Summary
This summary is machine-generated.

Women undergoing contralateral prophylactic mastectomy with immediate bilateral breast reconstruction face risks. Complications are less common in the noncancerous breast compared to the cancerous breast, aiding patient counseling.

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Area of Science:

  • Oncology
  • Plastic Surgery
  • Breast Surgery

Background:

  • Increasing trend of contralateral prophylactic mastectomy with immediate bilateral breast reconstruction.
  • Prophylactic mastectomy carries inherent risks, even on the non-cancerous side.
  • Need to compare complication rates between cancerous and contralateral prophylactic breasts.

Purpose of the Study:

  • To compare complication rates between cancerous and contralateral prophylactic breasts in patients undergoing immediate bilateral breast reconstruction.
  • To evaluate the risks associated with operating on the non-cancerous breast during prophylactic mastectomy.
  • To provide data for informed patient counseling regarding treatment options and risks.

Main Methods:

  • Retrospective review of 160 patients undergoing immediate postmastectomy bilateral breast reconstruction for unilateral breast cancer (January 2008 - January 2019).
  • Data collected on demographics, cancer treatments, reconstruction type, hospital stay, and complications.
  • Comparison of complication rates between cancerous and noncancerous breasts.

Main Results:

  • Overall, 20.6% of patients experienced complications.
  • Complications were significantly more frequent in cancerous breasts (33 patients) than in noncancerous breasts (7 patients).
  • While radiation exposure increased complications on the affected side, cancer breasts had higher complication rates even without radiation exposure. However, specific complication rates showed no significant difference between sides after controlling for radiation.

Conclusions:

  • Contralateral prophylactic mastectomy with immediate bilateral reconstruction has added risks compared to unilateral procedures.
  • The incidence of complications is lower in the noncancerous breast than in the cancerous breast.
  • Findings aid in counseling patients with unilateral breast cancer about treatment risks and options.