Factors associated with the increasing trend of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ: Analysis of Surveillance, Epidemiology, and End Results data

You, Qiuting; Chen, Kai; Li, Yudong; Lai, Jianguo; Fang, Yichao; Shen, Shiyu; Liu, Yicheng; Su, Fengxi; Yu, Fang

doi:10.1016/j.breast.2018.05.001

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…[14][15][16][17][18] Consequently, earlier age at diagnosis and family history of BC/OC have been shown to be positively correlated with the decision to have CRRM in women with BC, regardless of genetic testing outcome. [19,37,38,46,[60][61][62] In this study, we did not observe any association between age at diagnosis and surgical decision when adjusted for GT result. However, all patients included in this study were 45 years old or younger, which hindered the ability to evaluate the impact of age at diagnosis on surgical decision making.…”

Section: Timely Cancer Genetic Counseling and Testing Young Women With Breast Cancercontrasting

confidence: 67%

“…The increase in CRRM rates ranges from of 4.2% to 9.6% over 8 years, to an increase of 5.4% to 37.5% over 15 years. [23,[33][34][35][36][37][38][39] TIMELY CANCER GENETIC COUNSELING AND TESTING YOUNG WOMEN WITH BREAST CANCER Genetic testing availability has also increased over the past few decades, including increased utilization of multigene panel testing, which has increased the PV detection rates in genes other than BRCA1/2. [40][41][42] However, limited information exists regarding the impact of PVs in other BC predisposition genes on surgical decision-making outcomes for BC patients.…”

Section: Introductionmentioning

confidence: 99%

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Timely Cancer Genetic Counseling and Testing for Young Women With Breast Cancer: Impact on Surgical Decision-making for Contralateral Risk-reducing Mastectomy

Dettwyler

Thull

McAuliffe

et al. 2022

Preprint

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PURPOSE: Genetic testing (GT) can identify individuals with pathogenic variants (PV) in breast cancer (BC) predisposition genes, who may consider contralateral risk-reducing mastectomy (CRRM). We report on CRRM rates in young women newly diagnosed with BC who received GT through a multidisciplinary clinic. METHODS: Clinical data was reviewed for patients seen between November 2014 and June 2019. Patients with non-metastatic, unilateral BC diagnosed at age ≤45 and completed GT prior to surgery were included. Associations between surgical intervention and age, BC stage, family history, and GT results were evaluated. RESULTS: Of the 194 patients, 30 (15.5%) had a PV in a BC predisposition gene (ATM , BRCA1, BRCA2, CHEK2, NBN, NF1), with 66.7% in BRCA1 or BRCA2. Of 164 (84.5%) uninformative results, 132 (68%) were negative and 32 (16.5%) were variants of uncertain significance (VUS). Overall, 67 (34.5%) had CRRM, including 25/30 (83.3%) PV carriers and 42/164 (25.6%) non-carriers. Only a positive test result was associated with CRRM (p < 0.01). For the 164 with uninformative results, CRRM was not associated with age (p = 0.23), a VUS, (p = 0.08), family history (p = 0.19), or BC stage (p = 0.10). CONCLUSION: In this cohort of young women with BC, the identification of a PV in a BC predisposition gene was the only factor associated with the decision to pursue CRRM. Thus, incorporation of genetic services in the initial evaluation of young patients with a new BC could contribute to the surgical decision-making process.

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Section: Timely Cancer Genetic Counseling and Testing Young Women With Breast Cancercontrasting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Timely Cancer Genetic Counseling and Testing for Young Women With Breast Cancer: Impact on Surgical Decision-making for Contralateral Risk-reducing Mastectomy

Dettwyler

Thull

McAuliffe

et al. 2022

Preprint

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“…National guidelines for the surgical treatment of patients with DCIS recommend BCT with or without radiotherapy, or mastectomy if clinically indicated . Despite these guidelines, research has suggested that in the United States, the uptake of CPM in women with unilateral DCIS is increasing significantly . In a recent report using data from the Surveillance, Epidemiology, and End Results program regarding 105,326 patients with DCIS, the rates of CPM increased from 5.4% in 1998 to 37.5% in 2013 .…”

Section: Discussionmentioning

confidence: 99%

“…40,41 In a recent report using data from the Surveillance, Epidemiology, and End Results program regarding 105,326 patients with DCIS, the rates of CPM increased from 5.4% in 1998 to 37.5% in 2013. 40 The increasing rates of CPM for women with noninvasive breast cancer may reflect the availability of immediate breast reconstruction. In the current study, approximately 75.4% of women with noninvasive breast cancer underwent immediate breast reconstruction compared with 18.1% of women with invasive breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Despite these guidelines, research has suggested that in the United States, the uptake of CPM in women with unilateral DCIS is increasing significantly . In a recent report using data from the Surveillance, Epidemiology, and End Results program regarding 105,326 patients with DCIS, the rates of CPM increased from 5.4% in 1998 to 37.5% in 2013 . The increasing rates of CPM for women with noninvasive breast cancer may reflect the availability of immediate breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of uptake of contralateral prophylactic mastectomy in women with nonhereditary breast cancer

Metcalfe

Retrouvey

Kerrebijn

et al. 2019

Cancer

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Background The rates of contralateral prophylactic mastectomy (CPM) are increasing in women with breast cancer. Previous retrospective research has examined clinical and demographic predictors of the uptake of CPM. However, to the authors' knowledge, there has been very little prospective research to date that has examined psychosocial functioning prior to breast cancer surgery to determine whether psychosocial functioning predicts uptake of CPM. The current study was conducted to evaluate demographic, clinical, and psychosocial predictors of the uptake of CPM in women with unilateral breast cancer without a BRCA1 or BRCA2 mutation. Methods Women with unilateral non–BRCA‐associated breast cancer completed questionnaires prior to undergoing breast cancer surgery. Participants completed demographic and psychosocial questionnaires assessing anxiety, depression, cancer‐related distress, optimism/pessimism, breast satisfaction, and quality of life. Pathological and surgical data were collected from medical charts. Results A total of 506 women consented to participate, 112 of whom (22.1%) elected to undergo CPM. Age was found to be a significant predictor of CPM, with younger women found to be significantly more likely to undergo CPM compared with older women (P < .0001). The rate of CPM was significantly higher in women with noninvasive breast cancer compared with those with invasive breast cancer (P < .0001). Women who elected to undergo CPM had lower levels of presurgical breast satisfaction (P = .01) and optimism (P = .05) compared with women who did not undergo CPM. Conclusions Psychosocial functioning at the time of breast cancer surgery decision making impacts decisions related to CPM. Women who have lower levels of breast satisfaction (body image) and optimism are more likely to elect to undergo CPM. It is important for health care providers to take psychosocial functioning into consideration when discussing surgical options.

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Bilateral Mastectomy in Women With Unilateral Breast Cancer

2021

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Factors associated with the increasing trend of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ: Analysis of Surveillance, Epidemiology, and End Results data

Cited by 8 publications

References 31 publications

Timely Cancer Genetic Counseling and Testing for Young Women With Breast Cancer: Impact on Surgical Decision-making for Contralateral Risk-reducing Mastectomy

Timely Cancer Genetic Counseling and Testing for Young Women With Breast Cancer: Impact on Surgical Decision-making for Contralateral Risk-reducing Mastectomy

Predictors of uptake of contralateral prophylactic mastectomy in women with nonhereditary breast cancer

Bilateral Mastectomy in Women With Unilateral Breast Cancer

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