National trends in contralateral prophylactic mastectomy in women with locally advanced breast cancer Journal Article


Authors: Panchal, H.; Pilewskie, M. L.; Sheckter, C. C.; Albornoz, C. R.; Razdan, S. N.; Disa, J. J.; Cordeiro, P. G.; Mehrara, B. J.; Matros, E.
Article Title: National trends in contralateral prophylactic mastectomy in women with locally advanced breast cancer
Abstract: Background and Objectives: Women with unilateral early-stage breast cancer are increasingly choosing contralateral prophylactic mastectomy (CPM) despite the absence of survival benefits and increased risk of surgical complications. Data are lacking on whether this trend extends to women with clinically locally advanced nonmetastatic (cT4M0) cancer. This study aims to estimate national CPM trends in women with unilateral cT4M0 breast cancer. Methods: Women aged ≥ 18 years, who underwent mastectomy during 2004 to 2014 for unilateral cT4M0 breast cancer were identified using the National Cancer Database and grouped as all locally advanced (T4), chest wall invasion, skin nodule/ulceration, or both (T4abc), and inflammatory (T4d) cancer. Poisson regression for trends and logistic modeling for predictors of CPM were performed. Results: Of 23 943 women, 41% had T4abc disease and 35% T4d. Cumulative CPM rates were 15%, 23%, and 18%, for the T4abc, T4d, and all T4 groups, respectively. Trend analysis revealed a significant upsurge in CPM demonstrating 12% annual growth for T4abc tumors, 8% for T4d and 9% for all T4 (all P < 0.001). Conclusions: Increasing numbers of women with unilateral cT4M0 breast cancer are undergoing CPM. This rising trend warrants further research to understand stakeholders’ preferences in surgical decision-making for women with locally advanced breast cancer. © 2018 Wiley Periodicals, Inc.
Keywords: adult; controlled study; aged; middle aged; cancer surgery; young adult; major clinical study; cancer patient; cancer radiotherapy; antineoplastic agent; cancer incidence; breast cancer; cohort analysis; retrospective study; poisson distribution; cancer epidemiology; neoadjuvant chemotherapy; trend study; logistic regression analysis; thorax wall; skin nodule; skin ulcer; longitudinal study; prophylactic mastectomy; contralateral prophylactic mastectomy; inflammatory breast cancer; radical mastectomy; tumor invasion; human; female; priority journal; article; locally advanced breast cancer; contralateral prophylactic mastectomy (cpm); contralateral risk-reducing mastectomy; immediate breast reconstruction (ibr)
Journal Title: Journal of Surgical Oncology
Volume: 119
Issue: 1
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2019-01-01
Start Page: 79
End Page: 87
Language: English
DOI: 10.1002/jso.25315
PROVIDER: scopus
PUBMED: 30480805
DOI/URL:
Notes: J. Surg. Oncol. -- Export Date: 2 January 2019 -- Article -- CODEN: JSONA C2 - 30480805 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Joseph Disa
    198 Disa
  2. Babak Mehrara
    256 Mehrara
  3. Peter G Cordeiro
    239 Cordeiro
  4. Evan Matros
    72 Matros
  5. Shantanu N Razdan
    14 Razdan
  6. Hinaben J Panchal
    10 Panchal