Surgeon Input on Contralateral Prophylactic Mastectomy Needed

Surgeon Input on Contralateral Prophylactic Mastectomy Needed

WEDNESDAY, Dec. 21, 2016 (HealthDay News) — Many patients with newly diagnosed unilateral breast cancer consider contralateral prophylactic mastectomy (CPM), according to a study published online Dec. 21 in JAMA Surgery.

Reshma Jagsi, M.D., D.Phil., from the University of Michigan in Ann Arbor, and colleagues examined patient motivations, knowledge, and decisions, and the impact of surgeon recommendations on use of CPM. A total of 2,402 women with newly diagnosed, unilateral, stage 0, I, or II breast cancer were surveyed.

The researchers found that 43.9 percent of women considered CMP (24.8 percent considered it strongly or very strongly); more than one-third (38.1 percent) of them knew that CPM does not improve survival for all women with breast cancer. Ultimately, 61.6, 21.2, and 17.3 percent received breast-conserving surgery, unilateral mastectomy, and CPM, respectively. On multivariable analysis, factors associated with CPM included younger age, white race, higher educational level, family history, and private insurance. For the 1,569 patients without high genetic risk or an identified mutation, 39.3 percent reported a surgeon recommendation against CPM; only 1.9 percent of these women underwent CPM. Among the women who received no recommendation from a surgeon, 19.0 percent underwent CPM.

“Many patients consider CPM, but knowledge about the procedure is low and discussions with surgeons appear to be incomplete,” the authors write. “More effective physician-patient communication about CPM is needed to reduce potential overtreatment.”

One author disclosed financial ties to the biotechnology industry.

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