Increasing rates of contralateral prophylactic mastectomy – A trend made in USA?

Güth, Uwe; Myrick, Mary Elizabeth; Viehl, Carsten T.; Weber, Walter; Lardi, Alessia M.; Schmid, SM

doi:10.1016/j.ejso.2011.12.014

Cited by 67 publications

(45 citation statements)

References 27 publications

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“…Interestingly, the factors associated with increased rates of immediate CPM at our institution are similar to those found in the United States literature -suggesting that the patient factors influencing the decision to undergo a CPM are possibly the same between the two countries. Within our population, younger patients and those with family history were more likely to undergo CPM, similar to patients in the numerous United States studies [1][2][3]7,8,[12][13][14] . Furthermore, the use of immediate reconstruction has been associated with increased CPM rates [11,13] , and our study results support this finding.…”

Section: Discussionmentioning

confidence: 68%

“…During this time period, our CPM rate was 6.4% (range: 2.6% to 10.7%) with no increase over time, while rates in the United States were noted to increase between 2003 and 2010 from 4.1% to 9.7% for all ages, and 9.3% to 24.1% for patients aged 45 years or less [1] . In contrast, during a similar time period in Switzerland, CPM rates remained stable at 7% [8] . In Canada, the only reported data examined national CPM rates between 2007 and 2010 and demonstrated an overall CPM rate of 6% (5% in 2007/2008 to 7% in 2009/2010) -consistent with our institutional results and the rates from Switzerland [8,10] .…”

Section: Discussionmentioning

confidence: 87%

“…In contrast, during a similar time period in Switzerland, CPM rates remained stable at 7% [8] . In Canada, the only reported data examined national CPM rates between 2007 and 2010 and demonstrated an overall CPM rate of 6% (5% in 2007/2008 to 7% in 2009/2010) -consistent with our institutional results and the rates from Switzerland [8,10] . Interestingly, the factors associated with increased rates of immediate CPM at our institution are similar to those found in the United States literature -suggesting that the patient factors influencing the decision to undergo a CPM are possibly the same between the two countries.…”

Section: Discussionmentioning

confidence: 87%

“…CPM trends of similar magnitude and scope have not been quantitatively documented in literature from countries outside of the United States. Switzerland and England have reported much lower CPM rates during a similar time period as the United States data [8,9] -with no significant increase over time noted in Switzerland. It is possible that in these countries, as well as in Canada, where the health care system is based on a socialized medicine model, and surgeons routinely practice under budgetary restraints; a nonlife-saving surgical service such as CPM may not be as readily available as in the United States.…”

Section: Introductionmentioning

confidence: 87%

“…In Canada, lower CPM rates have been noted on a national level compared to the United States [10] , but these rates were obtained through administrative databases and no patient level, surgical procedure detail, or outcomes data were reported [10] . Since CPM rates are known to be influenced by resource factors, such as access to genetic testing and immediate breast reconstruction, and other patient factors such as age [1][2][3]7,8,[11][12][13][14] , examining CPM trends with patient and procedure level data will provide more detailed information on the CPM landscape in Canada. Therefore, our main objective was to examine the rates and trends of immediate CPM and to compare outcomes of patients undergoing CPM to patients having unilateral mastectomy (UM) alone at a Canadian academic breast cancer center.…”

Section: Introductionmentioning

confidence: 99%

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Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

Roberts

Sandhu

Cil

et al. 2016

WJCO

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AIM:To examine trends of contralateral prophylactic mastectomy (CPM) rates at a Canadian academic breast cancer center. METHODS:A single-institution retrospective cohort study was completed. Women of any age who underwent at least a unilateral mastectomy (UM) for primary unilateral breast carcinoma between January 1, 2004 and December 31, 2010 were included. Patients who underwent CPM on the same day as UM were isolated to create two distinct cohorts. Patient and procedure characteristics were compared across groups using R software (version 3.1.0). The percentage of CPMs per year was determined. The Cochrane-Armitage test was used to assess the trend of CPMs over time. A P value of < 0.05 was considered significant. RESULTS:A total of 811 women met the inclusions/ exclusion criteria; 759 (93.6%) underwent UM alone and 52 (6.4%) underwent UM with immediate CPM. The absolute number of procedures (UM and UM + CPM) increased over time, from 83 in 2004 to 147 in 2010 reflecting an increase in mastectomy volume. Annual CPM rates did not increase over time (P = 0.7) and varied between 2.6% to 10.7%.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

Roberts

Sandhu

Cil

et al. 2016

WJCO

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Neoplasms of the Breast

Rugo

Majure

Dragun

et al. 2017

Holland‐Frei Cancer Medicine

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Overview Breast cancer in women remains a major medical problem with significant public health and societal ramifications, including issues related to screening, risk factors, prevention, diagnosis, treatment, and survival following diagnosis. Major advances have markedly improved the understanding of clinical phenotypes, as well as the biologic pathways that drive tumor growth and resistance. This research has led to dramatic changes in treatment that have contributed to a significant reduction in breast cancer mortality over the last two decades, and is the basis of ongoing clinical research. Molecular profiling has provided insights into the heterogeneity of breast cancer subtypes; combining biology and tumor burden has allowed stratification of both risk and treatment to begin the process of individualizing screening, prevention, and treatment. As new information accumulates, new paradigms of management become the standard of care reflected in international guidelines. Our challenge is to apply new formation and treatment appropriately and effectively, and to understand both response and resistance. Information obtained from molecular, biologic, and pathologic investigations and clinical trials provides the major focus of this chapter.

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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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Increasing rates of contralateral prophylactic mastectomy – A trend made in USA?

Cited by 67 publications

References 27 publications

Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

Neoplasms of the Breast

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

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