Factors Associated With Increased Contralateral Breast Cancer Risk

  • Factors associated with increased contralateral breast cancer risks include:
    • Genetic mutations:
      • Such as:
        • BRCA1 mutations
        • BRCA 2 mutations
        • Chek2 mutations
        • Atm mutations
        • Palb2 mutations
    • History of mantle radiation
    • First-degree relative with breast cancer
    • Young age at diagnosis
    • Hormone negative disease
  • To consider contralateral prophylactic mastectomy (CPM):
    • The disease burden of the primary tumor needs to be lower than the risk of contralateral breast cancer
  • For an average risk patient:
    • Contralateral cancer risk ranges from 1% to 5%
  • Markov models for stage 1 and 2 breast cancer patients:
    • Showed overall survival benefit of less than 1% in patients who had CPM
  • CPM may offer a survival advantage for:
    • Women less than 50 years of age who are diagnosed with triple negative breast cancer
  • References
    • Deshmukh AA, Cantor SB, Crosby MA, Dong W, Shen Y, Bedrosian I, et al. Cost of contralateral prophylactic mastectomy. Ann Surg Oncol. 2014;21(9):2823-2830.
    • Roberts A, Habibi M, Frick KD. Cost-effectiveness of contralateral prophylactic mastectomy for prevention of contralateral breast cancer. Ann Surg Oncol. 2014;21(7):2209-2217.
    • Frost MH, Hoskin TL, Hartmann LC, Degnim AC, Johnson JL, Boughey JC. Contralateral prophylactic mastectomy: long-term consistency of satisfaction and adverse effects and the significance of informed decision-making, quality of life, and personality traits. Ann Surg Oncol. 2011;18(11):3110-3116.
    • Barton MB, West CN, Liu IL, Harris EL, Rolnick SJ, Elmore JG, et al. Complications following bilateral prophylactic mastectomy. J Natl Cancer Inst Monogr. 2005;(35):61-66.
    • Grann VR, Jacobson JS, Whang W, Hershman D, Heitjan DF, Antman KH, et al. Prevention with tamoxifen or other hormones versus prophylactic surgery in BRCA1/2-positive women: a decision analysis. Cancer J Sci Am. 2000;6(1):13-20.
    • Portschy PR, Kuntz KM, Tuttle TM. Survival outcomes after contralateral prophylactic mastectomy: a decision analysis. J Natl Cancer Inst. 2014;106(8).

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