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Synchronous, bilateral mastectomy

E D Staren1, D A Robinson, T R Witt

  • 1Department of General Surgery, Rush Medical College, Chicago, Illinois, USA.

Journal of Surgical Oncology
|June 1, 1995
PubMed
Summary
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Bilateral mastectomy unexpectedly revealed cancer in 34% of contralateral breasts, especially with noninvasive lobular carcinoma. This suggests bilateral mastectomy may be suitable for select patients with concerning risk factors.

Area of Science:

  • Oncology
  • Surgical Pathology

Background:

  • Bilateral mastectomy is performed for various breast cancer indications.
  • Contralateral breast findings after bilateral mastectomy are not fully characterized.

Purpose of the Study:

  • To investigate the incidence of unexpected contralateral breast carcinoma in patients undergoing bilateral mastectomy.
  • To identify patient and tumor characteristics associated with unexpected contralateral findings.

Main Methods:

  • Retrospective review of 64 patients undergoing bilateral mastectomy.
  • Analysis of pre-mastectomy biopsy results and final mastectomy specimen pathology.

Main Results:

  • Unexpected carcinoma was found in 34% of contralateral breasts (10 of 29) in patients with unilateral carcinoma on biopsy.

Related Experiment Videos

  • Noninvasive lobular carcinoma was the most common unexpected finding in the contralateral breast.
  • Bilateral mastectomy was performed in 13 patients with benign disease or no biopsy on initial assessment.

    • Conclusions:

    • A significant rate of unexpected contralateral breast carcinoma exists in patients selected for bilateral mastectomy.
    • Noninvasive lobular histology and strong family history may warrant consideration for bilateral mastectomy.
    • Careful patient selection is crucial, especially when physical or mammographic assessment is challenging.