Surveillance of prophylactic mastectomy

McLaughlin, Colleen C.; Lillquist, Patricia P.; Edge, Stephen B.

doi:10.1002/cncr.24623

Cited by 75 publications

(44 citation statements)

References 58 publications

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“…This is in contrast to other epidemiologic studies involving CPM, which consisted of predominantly white non-Hispanic patients (Carey et al, 2006;Kurian et al, 2009). Similar to previous epidemiologic studies (Tuttle et al, 2007;Jones et al, 2009;Katipamula et al, 2009;McLaughlin et al, 2009), our study population largely consisted of patients diagnosed between 2000-2010 (49.8%). Among this later timeframe, there was a 3-fold increase in the total number of CPM's compared with the earlier timeframes analyzed in this study.…”

Section: Discussionmentioning

confidence: 71%

“…Despite mixed survival data (Peralta et al, 2000;Bedrosian et al, 2010;Boughey et al, 2010;Narod et al, 2011;Zendejas et al, 2011), the utilization of CPM for the prevention of CBC increased significantly over the past 15 years, especially among young women (Jones et al, 2009;Katipamula et al, 2009;McLaughlin et al, 2009;Tuttle et al, 2007;. In response to rising rates, the Society of Surgical Oncology (SSO) updated their position statement in 2007 and emphasized that indications for CPM should only include any of the following: i) BRCA mutations or other genetic susceptibility genes; ii) strong family history with no demonstrable mutation; and iii) histologic risk factors (Position Statement, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Improved Long-term Survival with Contralateral Prophylactic Mastectomy among Young Women

Zeichner

Ruiz²,

Markward³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Despite mixed survival data, the utilization of contralateral prophylactic mastectomy (CPM) for the prevention of a contralateral breast cancer (CBC) has increased significantly over the last 15 years, especially among women less than 40. We set out to look at our own experience with CPM, focusing on outcomes in women less than 40, the sub-population with the highest cumulative lifetime risk of developing CBC. With an extended follow-up, we hoped to demonstrate differences in the long-term disease free survival (DFS) and overall survival ( We found that CPM has increased dramatically over the last 15 years, especially among white women with locally advanced disease. In patients less than 40, who are thought to be at greatest cumulative risk of secondary breast cancer, CPM provided an OS advantage, regardless of genetics, tumor or patient characteristics, and which was only seen after 10 years of follow-up.Keywords: Contralateral prophylactic mastectomy -contralateral breast cancer -young women breast cancer

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Improved Long-term Survival with Contralateral Prophylactic Mastectomy among Young Women

Zeichner

Ruiz²,

Markward³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…We cannot compare the relative efficacy of subcutaneous mastectomy and total Although 80 % of BC after PM occurred in patients who underwent subcutaneous mastectomy, subcutaneous mastectomy was by far the more common procedure in the BPM patients [6] and was also performed in a significant number of CPM patients [16]. The fact that BC after PM occurred in patients who underwent total mastectomy highlights that BC after PM will continue to occur in the present era of risk-reducing surgery, particularly in the context of increasing rates of CPM and BPM [7]. Therefore, consideration of optimal management of these patients is important.…”

Section: Discussionmentioning

confidence: 91%

“…Bilateral prophylactic mastectomy (BPM) is a well-recognized risk reduction option for women at high risk of BC, such as those with known mutations in BRCA1 or BRCA2 or a strong family history of BC [4][5][6]. Rates of BPM are also increasing, likely because of increased awareness of familial risk and improved access to genetic counseling and genetic testing [7].…”

Section: Introductionmentioning

confidence: 99%

Breast cancer after prophylactic mastectomy (bilateral or contralateral prophylactic mastectomy), a clinical entity: presentation, management, and outcomes

Mutter

Frost

Hoskin

et al. 2015

Breast Cancer Res Treat

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Contralateral prophylactic mastectomy (CPM) and bilateral prophylactic mastectomy (BPM) markedly decrease the possibility of new breast cancer (BC) ipsilateral to the prophylactic mastectomy (PM). Given its relative infrequency, little is known about the clinical characteristics, presentation, and management of BC after PM. Between 1960 and 1993, 1065 women underwent BPM and 1643 women with unilateral BC treated with therapeutic mastectomy underwent CPM at our institution. Medical records were reviewed, and study-specific questionnaires were sent to all women. BC after PM included locoregional invasive BC or ductal carcinoma in situ ipsilateral to the PM. BC developed ipsilateral to the PM in 25 patients (13 after BPM; 12 after therapeutic mastectomy and CPM). Median follow-up after PM was 22 years (range 3-34 years). Presentations included clinically isolated local disease in 17 patients (68%); disease limited to the axilla without evidence of local primary disease in 4 (16%); synchronous local and axillary disease in 1 (4%); and synchronous local disease and distant metastases in 3 (12%). The 17 patients presenting with isolated local disease were most commonly managed with completion or redo mastectomy (65%) or local excision (29 %), followed by consideration of adjuvant therapy. The 5-year disease-free survival estimate was 69% (95% CI 52-94%) for the 22 patients who had isolated locoregional BC after PM and were treated with curative intent. Although rare, BC after PM can occur. The most common presentation, disease localized to the mastectomy site, can be managed with resection and consideration of adjuvant therapy.

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“…Although, it appears to have been increasing during the last decade [11][12][13][14], a majority of women carrying a BRCA1/2 mutation still do not choose prophylactic breast surgery. There is thus a need to evaluate medical prevention for BRCA1/2 carriers who do not opt for mastectomy.…”

Section: Introductionmentioning

confidence: 97%

Uptake of a randomized breast cancer prevention trial comparing letrozole to placebo in BRCA1/2 mutations carriers: the LIBER trial

et al. 2011

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Women with germline BRCA1 or BRCA2 (BRCA1/2) mutations are considered as an extreme risk population for developing breast cancer. Prophylactic mastectomy provides a valid option to reduce such risk, impacting however, the quality of life. Medical prevention by aromatase inhibitor that has also recently shown to have preventive effect may thus be considered as an alternative. LIBER is an ongoing double-blind, randomized phase III trial to evaluate the efficacy of 5-year letrozole versus placebo to decrease breast cancer incidence in post-menopausal BRCA1/2 mutation carriers (NCT00673335). We present data on the uptake of this trial. We compared characteristics of women in the LIBER trial (n = 113) to those of women enrolled in the prospective ongoing national GENEPSO cohort (n = 1,505). Uptake was evaluated through a survey sent to all active centres, with responses obtained from 17 to the 20 (85%) centres. According to the characteristics of the women enrolled in the GENEPSO cohort and the survey, approximately one-third of BRCA1/2 mutation carriers were eligible for the trial. Five hundred and thirty-four women eligible from chart review have been informed by mail about the prevention trial and were invited to an oral information by participating centres. Forty-four percentage of them came to the dedicated medical visit. Uptake of drug prevention trial was 32% among women informed orally and 15% of all the eligible women. The main reasons of refusal were: potential side effects, probability to receive the placebo and lack of support from their physicians. Additionally, we noticed that prior prophylactic oophorectomy and previous unilateral breast cancer were more frequent in women enrolled in the LIBER trial than in the French cohort (93% vs. 60% and 50% vs. 39%, respectively). Based on an overall 15% uptake among all eligible subjects, greater and wider information of the trial should be offered to women with BRCA1/2 mutation to improve recruitment. Women with previous unilateral breast cancer or prior prophylactic oophorectomy are more likely to enter a medical prevention trial.

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Surveillance of prophylactic mastectomy

Abstract: BACKGROUND: Prophylactic mastectomy, prophylactic oophorectomy, and antiestrogen chemoprevention are currently the only available methods for breast cancer risk reduction. To the authors' knowledge there

Cited by 75 publications

References 58 publications

Improved Long-term Survival with Contralateral Prophylactic Mastectomy among Young Women

Improved Long-term Survival with Contralateral Prophylactic Mastectomy among Young Women

Breast cancer after prophylactic mastectomy (bilateral or contralateral prophylactic mastectomy), a clinical entity: presentation, management, and outcomes

Uptake of a randomized breast cancer prevention trial comparing letrozole to placebo in BRCA1/2 mutations carriers: the LIBER trial

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