Many Consider Contralateral Prophylactic Mastectomy
Wednesday, May 28, 2014 (Last Updated: 05/29/2014)
WEDNESDAY, May 28, 2014 (HealthDay News) -- A considerable proportion of women with breast cancer consider contralateral prophylactic mastectomy (CPM), according to a study published online May 21 in JAMA Surgery.
Sarah T. Hawley, Ph.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues examined factors associated with use of CPM in a longitudinal survey of women newly diagnosed with breast cancer. A total of 1,447 women were included in the analytical sample.
The researchers found that 18.9 percent of women strongly considered CPM and 7.6 percent received it. Of those who strongly considered CPM, 32.2, 45.8, and 22.8 percent, respectively, received CPM, unilateral mastectomy (UM), and breast conservation surgery (BCS). No major genetic or familial risk factors for contralateral disease were identified in the majority of women who received CPM (68.9 percent). Significant correlations were seen for CPM with genetic testing (positive or negative; versus UM and BCS: relative risk ratios [RRRs], 10.48 and 19.10, respectively; P < 0.001); strong family history of breast or ovarian cancer (RRRs, 5.19 and 4.24, respectively; P = 0.001); receipt of magnetic resonance imaging (RRRs, 2.07 and 2.14, respectively; P = 0.001); higher education (RRRs, 5.04 and 4.38, respectively; P < 0.001); and greater worry about recurrence (RRRs, 2.81 and 4.24, respectively; P = 0.001).
"Many women considered CPM and a substantial number received it, although few had a clinically significant risk of contralateral breast cancer," the authors write. "Worry about recurrence appeared to drive decisions for CPM although the procedure has not been shown to reduce recurrence risk."
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