Contralateral prophylactic mastectomy in a rural population: A single-institution experience

Area of Science:

• Oncology
• Surgical Oncology
• Public Health

Background:

• Contralateral prophylactic mastectomy (CPM) for unilateral breast cancer (UBC) is increasing, despite limited survival benefits for average-risk patients.
• Previous studies indicated a 21.8% CPM rate from 2000-2009 at this institution.
• This study investigates CPM trends in a rural population and identifies rates in average-risk individuals.

Purpose of the Study:

• To evaluate the trend of contralateral prophylactic mastectomy (CPM) for unilateral breast cancer (UBC) at a single institution serving a rural population.
• To determine the CPM rate in average-risk patients.
• To identify patient characteristics and associated risks for CPM.

Main Methods:

• Retrospective review of 438 patients who underwent mastectomy for UBC between 2017 and 2021.
• Analysis included descriptive statistics, chi-square tests, and independent sample t-tests.

Main Results:

• The CPM rate increased from 21.8% to 64.4% over two decades.
• Half (50.4%) of patients undergoing CPM had no identifiable risk factors for contralateral breast cancer (CBC).
• CPM patients were younger, more likely to have genetic testing, a family history of breast cancer, smaller tumors, undergo reconstruction, and experience more wound infections.

Conclusions:

• CPM rates have significantly increased in this rural population, with a substantial proportion of average-risk patients undergoing the procedure.
• CPM is associated with younger age, genetic factors, family history, smaller tumors, reconstruction, and increased wound infections.
• Understanding these trends and associated risks is crucial for informed patient counseling regarding CPM for UBC.