Should I Get a Prophylactic / Risk Reducing Contralateral Mastectomy?

• In the last 10 years there has been a significant focus on the role of contralateral prophylactic mastectomy and the risk of contralateral breast cancer.
• Single-institution studies and SEER data:
  • Have found contralateral prophylactic mastectomy rates:
    • To be as high as 25%:
      • And continue to increase:
        • Further, this trend seems to be limited to the United States
• Nichols et al:
  • Reviewed the rates of contralateral breast cancer using the SEER database between 1976 and 2006:
    • Overall, they found the rate of contralateral breast cancer to be declining:
      • Approximately 3% per year since 1985
    • From 1990 forward:
      • They found this benefit to be restricted to those>
        • Presenting with an ER-positive breast cancer>
          • With annual incidence rates of contralateral breast cancer of 0.25% to 0.37% when the index cancer was diagnosed after age 30 years
      • The rates of contralateral breast cancer were higher in patients with ER-negative breast cancers:
        • But still remained reasonably low:
          • With annual incidence rates of contralateral breast cancer of:
            • 0.45% to 0.65% when the index cancer was diagnosed after age 40 years
• Contralateral prophylactic mastectomy is attributed with approximately a:
  • 90% to 94% overall reduction in the risk of contralateral breast cancer:
    • Not 100%
  • Contralateral prophylactic mastectomy does not improve overall survival:
    • Recent modeling suggests:
      • The added absolute benefit of contralateral prophylactic mastectomy to overall survival:
        • Is less than 1.45%

👉Rodrigo Arrangoiz MS, MD, FACScirujano oncology y miembro de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

• Es experto en el manejo del patología de mama:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

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