The primary motive of this study was to evaluate the evidence for and acceptability of CPM, data on patient rationales for choosing CPM, and some of the factors that might impact patient preferences. This study suggests a strategy including shared decision-making to enhance surgeons’ communication with patients about contralateral breast cancer and treatment options. First, data on contralateral breast cancer risk and CPM rates and trends will be addressed to provide background on the current situation. This narrative review focuses on all types of CPM in women with stage I to stage III breast cancer. A Dutch population-based cohort study found a cumulative contralateral breast cancer incidence of 1.9% and 3.8% at 5 and 10 years, respectively. Three different contralateral breast cancer risk prediction models have been described in the literature. 10-12% of women treated for primary breast cancer developed distant recurrence during a mean follow-up of just over 5 years. Other factors that increase the risk of contralateral breast cancer to a smaller extent include younger age at primary breast cancer diagnosis, lobular histology,etc. The proportion of patients choosing CPM has an inverse relationship with age, ranging from 2.4% in patients 70 years or older to 29.3% in patients between 20 and 29 years old.
As a conclusion, the strategies provided in this study, if widely implemented, might contribute to closing the gap between patients’ choice for CPM and the more conservative approach that the guidelines prescribe for patients and it may lead to reduction in potentially harmful overtreatment.
Ref link- https://www.thebreastonline.com/article/S0960-9776(21)00017-5/fulltext