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Contralateral prophylactic mastectomy

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https://www.readbyqxmd.com/read/28770017/preoperative-genetic-testing-impacts-surgical-decision-making-in-brca-mutation-carriers-with-breast-cancer-a-retrospective-cohort-analysis
#1
Siddhartha Yadav, Ashley Reeves, Sarah Campian, Amy Sufka, Dana Zakalik
BACKGROUND: The impact of timing of genetic testing on surgical decision making in women with breast cancer and BRCA mutation is not well known. METHODS: Women who were found to carry a deleterious BRCA mutation and had been diagnosed with breast cancer were identified from a database at Beaumont Health. Women who had received BRCA positive results at least a day prior to their index surgery were considered to be aware of their mutation status prior to surgery. Baseline characteristics and surgical choices were compared between women who were aware of their mutation status prior to surgery and those who were not...
2017: Hereditary Cancer in Clinical Practice
https://www.readbyqxmd.com/read/28766231/contralateral-prophylactic-mastectomy-with-immediate-breast-reconstruction-increases-healthcare-utilization-and-cost
#2
Judy C Boughey, Stephanie R Schilz, Holly K Van Houten, Lin Zhu, Elizabeth B Habermann, Valerie Lemaine
BACKGROUND: The rates of contralateral prophylactic mastectomy (CPM) in women with unilateral breast cancer continue to rise, especially in women undergoing immediate breast reconstruction (IBR). METHODS: We utilized administrative claims data from a large US commercial insurance database (OptumLabs) to identify women age 18-64 years who underwent IBR between January 2004 and December 2013. We compared 2-year unadjusted utilization rates and total costs of care between unilateral mastectomy (UM) and bilateral mastectomy (BM) for implant-based and autologous reconstruction...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766225/influence-of-distance-to-hospital-and-insurance-status-on-the-rates-of-contralateral-prophylactic-mastectomy-a-national-cancer-data-base-study
#3
Erin P Ward, Jonathan T Unkart, Alex Bryant, James Murphy, Sarah L Blair
INTRODUCTION: We evaluated the impact of travel distance and insurance status on contralateral prophylactic mastectomy (CPM) rates in breast cancer. METHODS: We queried the National Cancer Data Base (NCDB) for women >18 years of age with a nonmetastatic primary breast cancer of ductal, lobular, or mixed histology. Patient- and facility-specific CPM rates were calculated based on insurance, race, and distance to treatment center. Standard univariable and multivariable regression analysis was performed...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766224/clinical-decision-making-in-patients-with-variant-of-uncertain-significance-in-brca1-or-brca2-genes
#4
Jessemae L Welsh, Tanya L Hoskin, Courtney N Day, Abigail S Thomas, Jodie A Cogswell, Fergus J Couch, Judy C Boughey
BACKGROUND: How diagnosis with a variant of uncertain significance (VUS) in a BRCA gene impacts clinical decision-making is not well known. METHODS: We queried for all patients attending Mayo Clinic Rochester from 2004 to 2016 who tested positive for BRCA1 or BRCA2 VUS and reviewed patient management choices. Groups were compared by using Wilcoxon rank-sum and Chi-square tests. RESULTS: We identified 97 patients (95 females, 2 males) with BRCA VUS...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766208/contralateral-breast-cancer-risk-in-women-with-ductal-carcinoma-in-situ-is-it-high-enough-to-justify-bilateral-mastectomy
#5
Megan E Miller, Shirin Muhsen, Cristina Olcese, Sujata Patil, Monica Morrow, Kimberly J Van Zee
BACKGROUND: Women with ductal carcinoma in situ (DCIS) are increasingly choosing bilateral mastectomy. We sought to quantify rates of contralateral breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) for DCIS, and to compare risk factors for CBC and IBTR. METHODS: From 1978 to 2011, DCIS patients undergoing BCS with a contralateral breast at risk were identified from a prospectively maintained database. The association of clinicopathologic and treatment factors with CBC and IBTR were evaluated using Kaplan-Meier analysis, multivariable Cox regression, and competing risk regression (CRR)...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766201/selective-use-of-sentinel-lymph-node-surgery-in-patients-undergoing-prophylactic-mastectomy-using-intraoperative-pathology
#6
Brittany L Murphy, Amy E Glasgow, Gary L Keeney, Elizabeth B Habermann, Judy C Boughey
BACKGROUND: Routine sentinel lymph node (SLN) surgery during prophylactic mastectomy (PM) is unnecessary, because most PMs do not contain cancer. Our institution utilizes intraoperative pathology to guide the surgical decision for resection of SLNs in PM. The purpose of this study was to review the effectiveness of this approach. METHODS: We identified all women aged ≥18 years who underwent bilateral PM (BPM) or contralateral PM (CPM) at our institution from January 2008 to July 2016...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28738941/disparities-in-rural-breast-cancer-care-factors-affecting-choice-of-breast-reconstruction-in-a-west-virginia-tertiary-care-hospital
#7
Tyler L Holliday, Patrick D Suggs, Stephanie N Thompson, Bryan K Richmond
The decision to pursue immediate postmastectomy breast reconstruction (IBR) is not uniform across all groups of women in the United States. We sought to investigate if the challenges of caring for a socioeconomically and geographically challenged rural population affected the incidence of IBR and to identify predictive factors of IBR in this population. Using our institution's cancer registry, we conducted a 10-year review of women with early-stage, unilateral breast cancer who received mastectomy. Demographics, insurance status, comorbidities, and surgeon graduation year were compared for patients receiving IBR versus no reconstruction...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738940/factors-affecting-choice-of-treatment-for-early-stage-breast-cancer-in-west-virginia-a-10-year-experience-from-a-rural-tertiary-care-center
#8
Patrick D Suggs, Tyler L Holliday, Stephanie N Thompson, Bryan K Richmond
Recent literature shows changing trends in use of breast conservation surgery (BCS), mastectomy, and contralateral prophylactic mastectomy (CPM) in women with early-stage breast cancer (ESBC). We analyzed factors associated with selection of these treatment modalities in a rural West Virginia tertiary care hospital. We conducted a 10-year analysis of women treated for ESBC at our institution from the institutional cancer registry. Variables were compared between patients choosing BCS versus mastectomy. In women who chose mastectomy, predictors for choice of CPM were also examined...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28690658/influence-of-the-angelina-jolie-announcement-and-insurance-reimbursement-on-practice-patterns-for-hereditary-breast-cancer
#9
Jihyoun Lee, Sungwon Kim, Eunyoung Kang, Suyeon Park, Zisun Kim, Min Hyuk Lee
Lack of awareness, the stigma of carrying a genetic mutation, and economic factors are barriers to acceptance of BRCA genetic testing or appropriate risk management. We aimed to investigate the influence of Angelina Jolie's announcement of her medical experience and also health insurance reimbursement for BRCA gene testing on practice patterns for hereditary breast and ovarian cancer (HBOC). A survey regarding changes in practice patterns for HBOC before and after the announcement was conducted online. The rate of BRCA gene testing was obtained from the National Health Insurance Review and Assessment Service database...
June 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28666919/age-molecular-subtypes-and-local-therapy-decision-making
#10
Anne Kuijer, Tari A King
The relationship between age and breast cancer subtype is complex: both impact risk of locoregional recurrence (LRR) and survival. Young patients frequently present with aggressive tumors but the increased risk imparted by young age appears to differ among breast cancer subtypes. Dramatic improvements in local control among young women with breast cancer of all tumor subtypes have been observed, likely attributable to improved local therapy strategies, improvements in adjuvant therapies and implementation of subtype-specific targeted therapies...
June 27, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28649642/disparities-in-contralateral-prophylactic-mastectomy-use-among-women-with-early-stage-breast-cancer
#11
Younji Kim, Anne Marie McCarthy, Mirar Bristol, Katrina Armstrong
Contralateral prophylactic mastectomy use has increased over the past decades among women with early-stage breast cancer. Racial differences in contralateral prophylactic mastectomy use are well described, but with unclear causes. This study examined contralateral prophylactic mastectomy use among black and white women and the contribution of differences in perceived risk to differences in use. We surveyed women diagnosed with early-stage unilateral breast cancer between ages 41-64 in Pennsylvania and Florida between 2007-2009 to collect data on breast cancer treatment, family history, education, income, insurance, and perceived risk...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28649032/a-standard-mastectomy-should-not-be-the-only-recommended-breast-surgical-treatment-for-non-metastatic-inflammatory-breast-cancer-a-large-population-based-study-in-the-surveillance-epidemiology-and-end-results-database-18
#12
Hongliang Chen, Kejin Wu, Maoli Wang, Fuwen Wang, Mingdi Zhang, Peng Zhang
BACKGROUND: Standard mastectomy has long been the recommended breast surgical treatment for non-metastatic inflammatory breast cancer (IBC). The objective of this population-based study was to evaluate the significance of various breast surgical treatments for this highly aggressive subtype. METHODS: The Surveillance, Epidemiology, and End Results program registry was searched to identify women with non-metastatic IBC receiving standard treatment including breast surgery, radiation therapy and chemotherapy diagnosed between 1998 and 2013...
June 22, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28634720/the-financial-impact-and-drivers-of-hospital-charges-in-contralateral-prophylactic-mastectomy-and-reconstruction-a-nationwide-inpatient-sample-hospital-analysis
#13
Alexandra Bucknor, Anmol Chattha, Klaas Ultee, Winona Wu, Parisa Kamali, Patrick Bletsis, Austin Chen, Bernard T Lee, Claire Cronin, Samuel J Lin
PURPOSE: Rates of contralateral prophylactic mastectomy (CPM) have increased over the last decade; it is important for surgeons and hospital systems to understand the economic drivers of increased costs in these patients. This study aims to identify factors affecting charges in those undergoing CPM and reconstruction. METHODS: Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample was undertaken (2009-2012), identifying women aged ≥18 with unilateral breast cancer undergoing unilateral mastectomy with CPM and immediate breast reconstruction (IBR) (CPM group), in addition to unilateral mastectomy and IBR alone (UM group)...
June 20, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28609204/surveillance-of-women-with-the-brca1-or-brca2-mutation-by-using-biannual-automated-breast-us-mr-imaging-and-mammography
#14
Jan C M van Zelst, Roel D M Mus, Gwendolyn Woldringh, Matthieu J C M Rutten, Peter Bult, Suzan Vreemann, Mathijn de Jong, Nico Karssemeijer, Nicoline Hoogerbrugge, Ritse M Mann
Purpose To evaluate a multimodal surveillance regimen including yearly full-field digital (FFD) mammography, dynamic contrast agent-enhanced (DCE) magnetic resonance (MR) imaging, and biannual automated breast (AB) ultrasonography (US) in women with BRCA1 and BRCA2 mutations. Materials and Methods This prospective multicenter trial enrolled 296 carriers of the BRCA mutation (153 BRCA1 and 128 BRCA2 carriers, and 15 women with first-degree untested relatives) between September 2010 and November 2012, with follow-up until November 2015...
June 13, 2017: Radiology
https://www.readbyqxmd.com/read/28594745/indications-for-contralateral-prophylactic-mastectomy-a-consensus-statement-using-modified-delphi-methodology
#15
Frances C Wright, Nicole J Look Hong, May Lynn Quan, Kaitlyn Beyfuss, Sara Temple, Andrea Covelli, Nancy Baxter, Anna R Gagliardi
OBJECTIVE: To reach a consensus about contralateral prophylactic mastectomy in unilateral breast cancer. SUMMARY BACKGROUND DATA: There has been a substantial increase in the number of North American women with unilateral breast cancer undergoing a therapeutic mastectomy and a contralateral prophylactic mastectomy (CPM) either simultaneously or sequentially. The purpose of this project was to create a nationally endorsed consensus statement for CPM in women with unilateral breast cancer using modified Delphi consensus methodology...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28589366/meta-analysis-of-pre-operative-magnetic-resonance-imaging-mri-and-surgical-treatment-for-breast-cancer
#16
REVIEW
Nehmat Houssami, Robin M Turner, Monica Morrow
BACKGROUND: Although there is no consensus on whether pre-operative MRI in women with breast cancer (BC) benefits surgical treatment, MRI continues to be used pre-operatively in practice. This meta-analysis examines the association between pre-operative MRI and surgical outcomes in BC. METHODS: A systematic review was performed to identify studies reporting quantitative data on pre-operative MRI and surgical outcomes (without restriction by type of surgery received or type of BC) and using a controlled design...
September 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28560595/trends-in-sexual-function-after-breast-cancer-surgery
#17
Lauren F Cornell, Dawn M Mussallem, Tammeza C Gibson, Nancy N Diehl, Sanjay P Bagaria, Sarah A McLaughlin
PURPOSE: Sexual dysfunction is assumed to be common, but understudied, in breast cancer patients. Herein, we use the validated female sexual functioning index (FSFI) to evaluate changes in female sexual function after breast cancer surgery. METHODS: The FSFI assesses sexual function in six domains (desire, arousal, lubrication, orgasm, satisfaction, pain) on a 36-point scale, with scores >26.6 indicating better sexual function. We identified 226 women with unilateral breast cancer undergoing surgery at our institution from June 2010-January 2015...
May 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28512732/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-1-lumpectomy-mastectomy-and-contralateral-prophylactic-mastectomy
#18
REVIEW
Lisa A Newman
Several prospective randomized clinical trials conducted internationally have proven the safety and survival equivalence of breast-conserving surgery compared with mastectomy. Adjuvant radiation is routinely recommended following lumpectomy surgery to minimize the risk of local recurrence. Comprehensive breast imaging (including bilateral mammography with diagnostic views and ultrasound evaluation), in addition to clinical examination, is essential to rule out potential contralateral pathology and to optimally characterize the extent of disease...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28439664/women-at-familial-risk-of-breast-cancer-electing-for-prophylactic-mastectomy-frequencies-procedures-and-decision-making-characteristics
#19
Sarah Schott, Lisa Vetter, Monika Keller, Thomas Bruckner, Michael Golatta, Sabine Eismann, Nicola Dikow, Christina Evers, Christof Sohn, Joerg Heil
BACKGROUND: Some women of families at high risk of breast cancer (BC) choose prophylactic mastectomy (PM) in spite of ambiguous evidence for survival benefits. The aim of this study was to investigate counselees' characteristics, decisions on PM, and frequencies of different procedures to better understand how to tailor interventions. PATIENTS AND METHODS: Eight hundred and forty-nine counselees who attended interdisciplinary consultation for genetic risk adjustment at the University Hospital Heidelberg between July 2009 and July 2011 received a tripartite questionnaire addressing sociodemographic characteristics, psychological parameters, behavioural questions, and medical data...
June 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28384687/patient-reactions-to-surgeon-recommendations-about-contralateral-prophylactic-mastectomy-for-treatment-of-breast-cancer
#20
Steven J Katz, Nancy K Janz, Paul Abrahamse, Lauren P Wallner, Sarah T Hawley, Lawrence C An, Kevin C Ward, Ann S Hamilton, Monica Morrow, Reshma Jagsi
Importance: Guidelines assert that contralateral prophylactic mastectomy (CPM) should be discouraged in patients without an elevated risk for a second primary breast cancer. However, little is known about the impact of surgeons discouraging CPM on patient care satisfaction or decisions to seek treatment from another clinician. Objective: To examine the association between patient report of first-surgeon recommendation against CPM and the extent of discussion about it with 3 outcomes: patient satisfaction with surgery decisions, receipt of a second opinion, and receipt of surgery by a second surgeon...
July 1, 2017: JAMA Surgery
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