TY - JOUR
T1 - Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy
T2 - Indications, Outcomes, and Risks
AU - Singh, Puneet
AU - Agnese, Doreen
AU - Amin, Miral
AU - Barrio, Andrea V.
AU - Botty Van den Bruele, Astrid
AU - Burke, Erin
AU - Danforth, David N.
AU - Dirbas, Frederick M.
AU - Eladoumikdachi, Firas
AU - Kantor, Olga
AU - Kumar, Shicha
AU - Lee, Marie Catherine
AU - Matsen, Cindy
AU - Nguyen, Toan T.
AU - Ozmen, Tolga
AU - Park, Ko Un
AU - Plichta, Jennifer K.
AU - Reyna, Chantal
AU - Showalter, Shayna L.
AU - Styblo, Toncred
AU - Tranakas, Nicholas
AU - Weiss, Anna
AU - Laronga, Christine
AU - Boughey, Judy
N1 - Publisher Copyright:
© Society of Surgical Oncology 2024.
PY - 2024/4
Y1 - 2024/4
N2 - Rates of contralateral mastectomy (CM) among patients with unilateral breast cancer have been increasing in the United States. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, risks, and benefits of CM since the society’s 2017 statement. We held a virtual meeting to outline key topics and then conducted a literature search using PubMed to identify relevant articles. We reviewed the articles and made recommendations based on group consensus. Patients consider CM for many reasons, including concerns regarding the risk of contralateral breast cancer (CBC), desire for improved cosmesis and symmetry, and preferences to avoid ongoing screening, whereas surgeons primarily consider CBC risk when making a recommendation for CM. For patients with a high risk of CBC, CM reduces the risk of new breast cancer, however it is not known to convey an overall survival benefit. Studies evaluating patient satisfaction with CM and reconstruction have yielded mixed results. Imaging with mammography within 12 months before CM is recommended, but routine preoperative breast magnetic resonance imaging is not; there is also no evidence to support routine postmastectomy imaging surveillance. Because the likelihood of identifying an occult malignancy during CM is low, routine sentinel lymph node surgery is not recommended. Data on the rates of postoperative complications are conflicting, and such complications may not be directly related to CM. Adjuvant therapy delays due to complications have not been reported. Surgeons can reduce CM rates by encouraging shared decision making and informed discussions incorporating patient preferences.
AB - Rates of contralateral mastectomy (CM) among patients with unilateral breast cancer have been increasing in the United States. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, risks, and benefits of CM since the society’s 2017 statement. We held a virtual meeting to outline key topics and then conducted a literature search using PubMed to identify relevant articles. We reviewed the articles and made recommendations based on group consensus. Patients consider CM for many reasons, including concerns regarding the risk of contralateral breast cancer (CBC), desire for improved cosmesis and symmetry, and preferences to avoid ongoing screening, whereas surgeons primarily consider CBC risk when making a recommendation for CM. For patients with a high risk of CBC, CM reduces the risk of new breast cancer, however it is not known to convey an overall survival benefit. Studies evaluating patient satisfaction with CM and reconstruction have yielded mixed results. Imaging with mammography within 12 months before CM is recommended, but routine preoperative breast magnetic resonance imaging is not; there is also no evidence to support routine postmastectomy imaging surveillance. Because the likelihood of identifying an occult malignancy during CM is low, routine sentinel lymph node surgery is not recommended. Data on the rates of postoperative complications are conflicting, and such complications may not be directly related to CM. Adjuvant therapy delays due to complications have not been reported. Surgeons can reduce CM rates by encouraging shared decision making and informed discussions incorporating patient preferences.
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U2 - 10.1245/s10434-024-14893-x
DO - 10.1245/s10434-024-14893-x
M3 - Review article
C2 - 38261126
AN - SCOPUS:85182853000
SN - 1068-9265
VL - 31
SP - 2212
EP - 2223
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 4
ER -