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Contralateral prophylactic mastectomy

Jessica Keim-Malpass, Aubrey Doede, Fabian Camacho, Christine Kennedy, Shayna L Showalter
Little is known about the role of low health literacy (LHL) among breast surgical oncology patients. We initiated a prospective health literacy assessment to determine the relationship between health literacy and surgical treatment. Among 512 patients, univariate analysis revealed no statistical significance in the relationship of health literacy to breast surgery type, contralateral prophylactic mastectomy, or reconstruction following mastectomy. In a multivariate analysis, women with LHL were less likely to undergo reconstruction (aOR 0...
March 14, 2018: Breast Journal
Patrick Bletsis, Alexandra Bucknor, Anmol Chattha, Parisa Kamali, Austin Chen, Renata Flecha-Hirsch, Berend van der Lei, Bernard T Lee, Samuel J Lin
BACKGROUND: Over the last decade, there has been a 12% increase in prophylactic mastectomy (PM) per year. The aim of the study was to analyze complication rates and associated risk factors in patients undergoing PM and reconstruction. METHODS: We reviewed patients undergoing PM (contralateral and bilateral) from 2010 to 2015 at a single academic institution. Data on patient characteristics and postoperative outcomes were obtained. Postoperative complications were categorized into minor and major groups...
February 23, 2018: Annals of Plastic Surgery
Shoshana M Rosenberg, Mary L Greaney, Andrea F Patenaude, Karen R Sepucha, Meghan E Meyer, Ann H Partridge
OBJECTIVE: Young women with unilateral breast cancer are increasingly choosing contralateral prophylactic mastectomy (CPM), despite its limited medical benefit for most women. The purpose of this study was to better understand this choice through a qualitative exploration of surgical decision-making in young survivors, including how issues particular to younger women affected their decision and the post-surgical experience. METHODS: Women age ≤40 years with stage 0-III breast cancer, 1-3 years from diagnosis who had undergone breast cancer surgery were recruited to participate...
February 24, 2018: Psycho-oncology
Christine Mau, Michael Untch
Risk-reducing surgery has proved to be a reasonable procedure in healthy women with a definitely elevated risk of developing cancer. Here we consider the elevated risk of breast and ovarian cancer. There is a clear indication for such surgery in healthy women with a pathogenic BRCA1/2 mutation. For these patients, a risk-reducing bilateral mastectomy leads to a verifiable reduction in mortality from breast cancer, particularly for young patients. In most cases, surgery is combined with breast reconstruction...
December 2017: Breast Care
Alessandro Fancellu, Valeria Sanna, Pietrina Cottu, Cladio F Feo, Antonio M Scanu, Giulia Farina, Antonio Bulla, Angela Spanu, Panagiotis Paliogiannis, Alberto Porcu
BACKGROUND: Recent literature reports that rates of mastectomy are increasing in early breast cancer. However, data from European institutions are limited and revealed conflicting results. We report on 15-year trends of mastectomy, mastectomy plus immediate reconstruction and contralateral prophylactic mastectomy (CPM) at an academic institution. METHODS: We identified women diagnosed with unilateral early breast cancer at stage 0-IIa, with tumour size ≤ 4 cm, between 2002 and 2016...
February 14, 2018: Breast: Official Journal of the European Society of Mastology
Evan Matros, Joseph J Disa
No abstract text is available yet for this article.
January 25, 2018: Plastic and Reconstructive Surgery
Holly J Pederson, Dharmesh Gopalakrishnan, Ryan Noss, Courtney Yanda, Charis Eng, Stephen R Grobmyer
BACKGROUND: With the advent of multi-gene panel testing for breast cancer patients, germline mutations with unknown association with cancer risk, known as variants of uncertain significance (VUS), are being increasingly identified. Some studies have shown higher rates of contralateral prophylactic mastectomies (CPM) in these patients despite lack of evidence to support this intervention. We analyzed surgical choices in patients who were identified to have VUS. METHODS: A retrospective review was performed of patients with TNBC treated at a single institution after multi-gene panel tests became available (09/01/2013- 02/28/2017)...
January 19, 2018: Journal of the American College of Surgeons
R Kenny, M Reed, A Subramanian
BACKGROUND: Prophylactic or 'risk-reducing' mastectomy refers to the procedure of completely removing a healthy breast in order to reduce the risk of developing breast cancer. This may be bilateral or may be performed to the contralateral breast as part of the treatment of a proven breast cancer. The rate of this procedure being performed has been shown to be increasing over the last two decades. Recent guidance for Breast clinicians has been issued over the last 12 months by both The Association of Breast Surgery of Great Britain and Ireland (ABSGBI) and the American Society of Breast Surgeons (ASBrS)...
December 26, 2017: International Journal of Surgery
Bonnie Jerome-DʼEmilia, Debashis Kushary, Patricia D Suplee
BACKGROUND: The rate of contralateral prophylactic mastectomy (CPM) in women with unilateral mastectomy is increasing with no plateau. OBJECTIVES: The aim of this study was to improve the understanding of patient- and tumor-related factors that influenced the choice of mastectomy with CPM as treatment for early-stage breast cancer at an academic medical center in New Jersey. METHODS: This was a retrospective analysis of 10 years of breast cancer data including 1556 women aged 40 to 80 years treated for breast cancer at an academic medical center...
December 14, 2017: Cancer Nursing
Rati Chkheidze, Mary Ann G Sanders, Barbara Haley, A Marilyn Leitch, Sunati Sahoo
BACKGROUND: Breast cancer metastases to an ipsilateral supraclavicular lymph node is assigned a N3 status in the TNM system and thus classified as stage III disease in the American Joint Commission on Cancer staging manual. Breast cancer metastatic to contralateral axillary lymph node (CAM) without metastases to any other distant organ is currently assigned M1 status (stage IV) instead of N3 (stage III). PATIENTS AND METHODS: We retrospectively reviewed the medical records of breast cancer patients diagnosed with CAM for their clinical presentation, pathologic diagnoses, treatment, and follow-up data...
November 10, 2017: Clinical Breast Cancer
Ian C Sando, Jessica I Billig, Shoshana W Ambani, Casey T Kraft, Kelley M Kidwell, Lin Zhong, Kevin C Chung, Adeyiza O Momoh
BACKGROUND: Rising contralateral prophylactic mastectomy rates are a subject of national concern. This study assessed (1) factors critical to patients when deciding on contralateral prophylactic mastectomy and (2) patients' quality of life related to concerns about recurrence after unilateral or bilateral breast reconstruction. METHODS: Patients with stage 0 to III breast cancer who underwent unilateral mastectomy or contralateral prophylactic mastectomy and breast reconstruction at a single institution between 2000 and 2012 were identified...
November 21, 2017: Annals of Plastic Surgery
Tracy Onega, Julie E Weiss, Martha E Goodrich, Weiwei Zhu, Wendy B DeMartini, Karla Kerlikowske, Elissa Ozanne, Anna N A Tosteson, Louise M Henderson, Diana S M Buist, Karen J Wernli, Sally D Herschorn, Elise Hotaling, Cristina O'Donoghue, Rebecca Hubbard
BACKGROUND AND OBJECTIVES: More extensive surgical treatments for early stage breast cancer are increasing. The patterns of preoperative MRI overall and by stage for this trend has not been well established. METHODS: Using Breast Cancer Surveillance Consortium registry data from 2010 through 2014, we identified women with an incident non-metastatic breast cancer and determined use of preoperative MRI and initial surgical treatment (mastectomy, with or without contralateral prophylactic mastectomy (CPM), reconstruction, and breast conserving surgery ± radiation)...
December 2017: Journal of Surgical Oncology
Hina Panchal, Evan Matros
Postmastectomy immediate breast reconstruction in the U.S. continues to experience an upward trend owing to heightened awareness, innovations in reconstructive technique, growing evidence of improved patient-reported outcomes, and shifts in mastectomy patterns. Women with unilateral breast cancer are increasingly electing to undergo contralateral prophylactic mastectomy, instead of unilateral mastectomy or opting for breast conservation. The ascent in prophylactic surgeries correlates temporally to a shift toward prosthetic methods of reconstruction as the most common technique...
November 2017: Plastic and Reconstructive Surgery
Judith R Greener, Sarah Bauerle Bass, Stephen J Lepore
The proportion of women with unilateral breast cancer and no familial or genetic risk factors who elect contralateral prophylactic mastectomy (CPM) has grown dramatically, even in the absence of clear data demonstrating improved outcomes. To further extend the literature that addresses treatment decision-making, qualitative interviews were conducted with eleven women who considered CPM. A social ecological model of breast cancer treatment decision-making provided the conceptual framework, and grounded theory was used to identify the cognitive, psychosocial, and emotional influences motivating treatment choice...
October 24, 2017: Journal of Psychosocial Oncology
John V Hegde, Xiaoyan Wang, Deanna J Attai, Maggie L DiNome, Amy Kusske, Anne C Hoyt, Sara A Hurvitz, Joanne B Weidhaas, Michael L Steinberg, Susan A McCloskey
INTRODUCTION: Contralateral prophylactic mastectomy (CPM) rates are rising, with fear implicated as a contributing factor. This study used a contralateral breast cancer (CBC) risk stratification tool to assess whether the selection of CPM is reflective of future CBC risk. PATIENTS AND METHODS: This retrospective study evaluated 404 women with unilateral breast cancer treated with breast conservation, unilateral mastectomy, or bilateral mastectomy within a single multidisciplinary clinic...
September 27, 2017: Clinical Breast Cancer
Robert C Keskey, A Scott LaJoie, Brad S Sutton, In K Kim, William G Cheadle, Kelly M McMasters, Nicolas Ajkay
BACKGROUND: Contralateral prophylactic mastectomy (CPM) rates in younger women with unilateral breast cancer have more than doubled. Studies of cost and quality of life of the procedure remain inconclusive. METHODS: A cost-effectiveness analysis using a decision-tree model in TreeAge Pro 2015 was used to compare long-term costs and quality of life following unilateral mastectomy (UM) with routine surveillance versus CPM for sporadic breast cancer in women aged 45 years...
October 16, 2017: Annals of Surgical Oncology
Rebecca A Marmor, Wenrui Dai, Xiaoqian Jiang, Shuang Wang, Sarah L Blair, Jina Huh
BACKGROUND: The increased uptake of contralateral prophylactic mastectomy (CPM) among breast cancer patients remains poorly understood. We hypothesized that the increased rate of CPM is represented in conversations on an online breast cancer community and may contribute to patients choosing this operation. METHODS: We downloaded 328,763 posts and their dates of creation from an online breast cancer community from August 1, 2000, to May 22, 2016. We then performed a keyword search to identify posts which mentioned breast cancer surgeries: contralateral prophylactic mastectomy (n = 7095), mastectomy (n = 10,889), and lumpectomy (n = 9694)...
October 2017: Journal of Surgical Research
Ramya Ramaswami, Monica Morrow, Reshma Jagsi
New England Journal of Medicine, Volume 377, Issue 13, Page 1288-1291, September 2017.
September 28, 2017: New England Journal of Medicine
Hannah Lui Park, Jenny Chang, Gagandeep Lal, Krustina Lal, Argyrios Ziogas, Hoda Anton-Culver
BACKGROUND: Although it is known that the risk of a second breast cancer event among young women diagnosed with ductal carcinoma in situ (DCIS) is higher than in older women, the effect of current treatment options on long-term outcomes in this subgroup of women remains poorly defined. We aimed to evaluate national treatment trends and determine their effect on second breast cancer risk and overall survival among young women diagnosed with DCIS. MATERIALS AND METHODS: Surveillance, Epidemiology, and End Results data from 1998 to 2011 were used to analyze 3648 DCIS patients younger than age 40 years...
August 10, 2017: Clinical Breast Cancer
James W Jakub, Anne Warren Peled, Richard J Gray, Rachel A Greenup, John V Kiluk, Virgilio Sacchini, Sarah A McLaughlin, Julia C Tchou, Robert A Vierkant, Amy C Degnim, Shawna Willey
Importance: Nipple-sparing mastectomy (NSM) offers superior cosmetic outcomes and has been gaining wide acceptance; however, its role among patients with BRCA mutations remains controversial. Objective: To report on the oncologic safety of NSM and provide evidence-based data to patients and health care professionals regarding preservation of the nipple-areolar complex during a risk-reducing mastectomy in a population with BRCA mutations. Design, Setting, and Participants: We retrospectively reviewed the outcomes of 9 institutions' experience with prophylactic NSM from 1968 to 2013 in a cohort of patients with BRCA mutations...
September 13, 2017: JAMA Surgery
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