Contralateral Mastectomy (CM) Rates in the USA.

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • In the United States (US), CM rates have been increasing for more than two decades:
    • One study using the Surveillance, Epidemiology, and End Results (SEER) database:
      • Showed that the rates of CM in patients with unilateral breast cancer (UBC) undergoing mastectomy increased:
        • From 4.2% in 1998 to 11.0% in 2003
    • A similar study using the National Cancer Database (NCDB):
      • Showed that the CM rate increased from 0.4% in 1998 to 4.7% in 2007
    • Since then, several other studies have demonstrated a continuation of this trend in the US:
      • Reporting CM rates as high as 30% to 50% in certain patient populations
  • This trend of increasing CM rates has also been seen in patients with ductal carcinoma in situ
  • Factors associated with undergoing CM are:
    • Caucasian race
    • Private insurance
    • Higher socioeconomic status
    • High volume centers
    • Younger age
    • Use of breast MRI
    • Genetic testing
    • Reconstructive surgery
  • Surgeons have also been shown to influence the likelihood of CM:
    • For example, if a surgeon recommends against CM:
      • The likelihood of undergoing CM decreases:
        • In a survey study of patients who underwent definitive surgery for breast cancer:
          • Those whose surgeons recommended against CM had a CM rate of 6.1%:
            • Whereas those who received no recommendation had a CM rate of 57.5
  • Shared decision making has been shown to reduce decision-related conflict and regret
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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