Trends in Contralateral Prophylactic Mastectomy.

Abstract:

INTRODUCTION:Many breast cancer patients remove their contralateral breast unaffected by cancer, commonly referred to as contralateral prophylactic mastectomy (CPM). CPM has been extensively studied and does not improve survival in patients without deleterious genetic mutation or lobular histology. Despite these limited indications, CPM rates have increased recently. We observed CPM trends in our county safety-net hospital. METHODS:We performed a retrospective review of women treated for breast cancer who underwent bilateral mastectomy in our institution. RESULTS:We analyzed 100 CPMs: 51% (n = 51) had bilateral breast MRI before CPM, 54% (n = 54) had genetic testing prior to CPM, and 56% (n = 30) had a deleterious genetic result. Another 12% (n = 12) had lobular histology as the primary determinant for CPM. Of patients without genetic mutation or lobular histology, 13% (n = 13) had suspicious MRI findings in the CPM side that drove the decision for CPM. Forty-seven percent (n = 47) had reconstructive surgery documented. CONCLUSION:Only 42% (n = 42) of patients who underwent CPM had a documented justifiable medical reason. In the future, physician and patient education may decrease unindicated CPM. We also found that 13% of women without a medical indication chose CPM based on suspicious MRI findings, while only 8% of these MRI findings were malignant. LEVEL OF EVIDENCE IV:This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

journal_name

Aesthetic Plast Surg

authors

Fairbairn K,Cervantes A,Rayhrer C,Steen S

doi

10.1007/s00266-019-01582-4

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

323-329

issue

2

eissn

0364-216X

issn

1432-5241

pii

10.1007/s00266-019-01582-4

journal_volume

44

pub_type

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