Assessing the Effect of Lifetime Contralateral Breast Cancer Risk on the Selection of Contralateral Prophylactic Mastectomy for Unilateral Breast Cancer
| Autor: | Michael L. Steinberg, Susan A. McCloskey, Amy M. Kusske, Maggie L. DiNome, John V. Hegde, Anne C. Hoyt, Joanne B. Weidhaas, Sara A. Hurvitz, Xiaoyan Wang, Deanna J. Attai |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Biopsy Logistic regression Mastectomy Segmental Risk Assessment Contralateral breast cancer 03 medical and health sciences 0302 clinical medicine Contralateral Prophylactic Mastectomy Breast cancer parasitic diseases medicine Unilateral Breast Neoplasms Humans 030212 general & internal medicine Breast Aged Retrospective Studies business.industry Obstetrics Carcinoma Ductal Breast Age Factors Prophylactic Mastectomy Retrospective cohort study Neoplasms Second Primary Odds ratio Fear Middle Aged medicine.disease Surgery Carcinoma Intraductal Noninfiltrating Oncology 030220 oncology & carcinogenesis Cohort Female business human activities |
| Zdroj: | Clinical breast cancer. 18(2) |
| ISSN: | 1938-0666 |
| Popis: | Contralateral prophylactic mastectomy (CPM) rates are rising, with fear implicated as a contributing factor. This study used a contralateral breast cancer (CBC) risk stratification tool to assess whether the selection of CPM is reflective of future CBC risk.This retrospective study evaluated 404 women with unilateral breast cancer treated with breast conservation, unilateral mastectomy, or bilateral mastectomy within a single multidisciplinary clinic. Women were evaluated by the Manchester risk tool to calculate lifetime CBC risk. Logistic regression analysis was used to evaluate whether CBC risk was associated with CPM, and the clinical rationale for prophylactic mastectomy justification was recorded.Sixty-two percent underwent breast conservation, 18% unilateral mastectomy, and 20% bilateral mastectomy. In the CPM cohort, 36% had20% calculated lifetime CBC risk. In the invasive cohort, younger age (odds ratio 2.65, P .0001) and genetic mutation positivity (odds ratio 35.39, P = .019) independently predicted CPM. Other contributing factors included benign contralateral breast findings (29%) and recommendations against breast conservation due to disease burden (28%). Six percent selected CPM as a result of an unsubstantiated fear regarding breast cancer.The majority of women (63%) who selected CPM had 20% CBC risk. In these lower-risk women selecting CPM, factors increasing reasonable fear dominated surgical choice (81% of this subset). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect