Society of Surgical Oncology Breast Disease Site Working Group statement on contralateral mastectomy: Indications, outcomes, and risks Review
| Authors: | Singh, P.; Agnese, D.; Amin, M.; Barrio, A. V.; Botty Van den Bruele, A.; Burke, E.; Danforth, D. N. Jr; Dirbas, F. M.; Eladoumikdachi, F.; Kantor, O.; Kumar, S.; Lee, M. C.; Matsen, C.; Nguyen, T. T.; Ozmen, T.; Park, K. U.; Plichta, J. K.; Reyna, C.; Showalter, S. L.; Styblo, T.; Tranakas, N.; Weiss, A.; Laronga, C.; Boughey, J. |
| Review Title: | Society of Surgical Oncology Breast Disease Site Working Group statement on contralateral mastectomy: Indications, outcomes, and risks |
| Abstract: | Rates of contralateral mastectomy (CM) among patients with unilateral breast cancer have been increasing in the United States. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, risks, and benefits of CM since the society’s 2017 statement. We held a virtual meeting to outline key topics and then conducted a literature search using PubMed to identify relevant articles. We reviewed the articles and made recommendations based on group consensus. Patients consider CM for many reasons, including concerns regarding the risk of contralateral breast cancer (CBC), desire for improved cosmesis and symmetry, and preferences to avoid ongoing screening, whereas surgeons primarily consider CBC risk when making a recommendation for CM. For patients with a high risk of CBC, CM reduces the risk of new breast cancer, however it is not known to convey an overall survival benefit. Studies evaluating patient satisfaction with CM and reconstruction have yielded mixed results. Imaging with mammography within 12 months before CM is recommended, but routine preoperative breast magnetic resonance imaging is not; there is also no evidence to support routine postmastectomy imaging surveillance. Because the likelihood of identifying an occult malignancy during CM is low, routine sentinel lymph node surgery is not recommended. Data on the rates of postoperative complications are conflicting, and such complications may not be directly related to CM. Adjuvant therapy delays due to complications have not been reported. Surgeons can reduce CM rates by encouraging shared decision making and informed discussions incorporating patient preferences. © Society of Surgical Oncology 2024. |
| Keywords: | cancer survival; treatment outcome; patient satisfaction; cancer surgery; review; postoperative period; cancer risk; cancer adjuvant therapy; cancer patient; preoperative evaluation; treatment indication; cancer susceptibility; breast cancer; mastectomy; genetic variability; evidence based practice; practice guideline; pathology; breast neoplasms; oncology; publication; risk factor; postoperative complication; health care cost; mammography; family history; breast tumor; surgeon; irradiation; surgical risk; medical society; medical oncology; medline; clinical decision making; patient decision making; treatment contraindication; tumor gene; genetic predisposition; patient counseling; patient preference; clinical trial (topic); breast magnetic resonance imaging; occult cancer; meta analysis (topic); shared decision making; partial body radiation; contralateral breast cancer; procedures; surgical oncology; contralateral mastectomy; systematic review (topic); cancer prognosis; hereditary breast cancer; sentinel lymph node metastasis; humans; human; female; patient history of radiotherapy; ethical decision making; unilateral breast neoplasms; chest irradiation; treatment interval; encouragement |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 4 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-04-01 |
| Start Page: | 2212 |
| End Page: | 2223 |
| Language: | English |
| DOI: | 10.1245/s10434-024-14893-x |
| PUBMED: | 38261126 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Source: Scopus |
