Recommendations for the use of Contralateral Mastectomy (CM) in patients with Unilateral Breast Cancer

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Contralateral mastectomy (CM) can be considered in:
    • Patients who have a high risk of contralateral breast cancer:
      • Due to:
        • A germline mutation
        • Prior chest irradiation
        • Strong family history
  • CM is contraindicated in:
    • Patients with comorbidities in whom the increased risk of surgical complications and / or the longer time under general anesthesia may be detrimental to their health
  • CM should be discouraged in:
    • Patients with metastatic disease:
      • Even if a palliative unilateral mastectomy is being considered
    • Patients with oligometastatic disease in whom a unilateral mastectomy, as recommended by a multidisciplinary care team or as part of a clinical trial:
      • Is being performed for curative intent
    • Patients with locally advanced breast cancer or inflammatory breast cancer:
      • For whom the expeditious delivery of adjuvant therapy may impact outcomes
    • Patients whose main reason for choosing CM is improving survival or decreasing the risk of a recurrence of their index cancer:
      • Despite proper counseling
    • Patients with a significant competing risk of mortality secondary to their breast cancer, other malignancies, or comorbidities
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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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