New Guidance for Decisions on Preventive Breast Surgery

Contralateral prophylactic mastectomy (CPM), a preventive procedure to remove the unaffected breast in patients with disease in the other breast, may only offer a survival benefit to a subgroup of breast cancer patients age 50 and younger, who have early-stage disease and are estrogen-receptor negative. The majority of women may not benefit from the procedure.

The first population-based study to find an association between the procedure and survival in cancer patients offers evidence to the women making this often agonizing decision and the physicians responsible for their care.

“In our clinic, we’ve seen a dramatic increase in the number of women requesting CPM, and across the breast cancer community, studies have shown that the use of the procedure is skyrocketing,” says Isabelle Bedrosian, M.D., assistant professor in MD Anderson’s Department of Surgical Oncology and the study’s co-corresponding author.

“Until now, we’ve counseled these patients on a very important personal decision in a vacuum,” she says. “With our study, our goal was to understand the implications of the surgery and who may benefit.”

Reported in the March 17 issue of the Journal of the National Cancer Institute.