Originally published as JCO Early Release 10.1200/JCO.2007.12.3141 on October 22 2007

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tuttle, T. M. Articles by Virnig, B. A. Search for Related Content PubMed PubMed Citation Articles by Tuttle, T. M. Articles by Virnig, B. A. Related Articles Related Correspondence Social Bookmarking                            What's this?

Increasing Use of Contralateral Prophylactic Mastectomy for Breast Cancer Patients: A Trend Toward More Aggressive Surgical Treatment

Todd M. Tuttle, Elizabeth B. Habermann, Erin H. Grund, Todd J. Morris, Beth A. Virnig

From the Department of Surgery, Division of Surgical Oncology; Division of Health Policy and Management, University of Minnesota School of Public Health; and the University of Minnesota Medical School, Minneapolis, MN

Address reprint requests to Todd M. Tuttle, MD, University of Minnesota, Department of Surgery, Division of Surgical Oncology, 420 Delaware St SE, Minneapolis, MN; e-mail: tuttl006{at}umn.edu

Purpose Many patients with unilateral breast cancer choose contralateral prophylactic mastectomy to prevent cancer in the opposite breast. The purpose of our study was to determine the use and trends of contralateral prophylactic mastectomy in the United States.

Patients and Methods We used the Surveillance, Epidemiology and End Results database to review the treatment of patients with unilateral breast cancer diagnosed from 1998 through 2003. We determined the rate of contralateral prophylactic mastectomy as a proportion of all surgically treated patients and as a proportion of all mastectomies.

Results We identified 152,755 patients with stage I, II, or III breast cancer; 4,969 patients chose contralateral prophylactic mastectomy. The rate was 3.3% for all surgically treated patients; 7.7%, for patients undergoing mastectomy. The overall rate significantly increased from 1.8% in 1998 to 4.5% in 2003. Likewise, the contralateral prophylactic mastectomy rate for patients undergoing mastectomy significantly increased from 4.2% in 1998 to 11.0% in 2003. These increased rates applied to all cancer stages and continued to the end of our study period. Young patient age, non-Hispanic white race, lobular histology, and previous cancer diagnosis were associated with significantly higher rates. Large tumor size was associated with a higher overall rate, but with a lower rate for patients undergoing mastectomy.

Conclusion The use of contralateral prophylactic mastectomy in the United States more than doubled within the recent 6-year period of our study. Prospective studies are needed to understand the decision-making processes that have led to more aggressive breast cancer surgery.

published online ahead of print at www.jco.org on October 22, 2007.

Presented in part at the Annual Meeting of the Society of Surgical Oncology, Washington, DC, March 16, 2007.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

Related Correspondence

• Contralateral Prophylactic Mastectomy: Mind the Genetics
  Evangelos Briasoulis and Dimitrios H. Roukos
  JCO 2008 26: 1909-1910 [Full Text]

This article has been cited by other articles:

				L. J. Solin Breast Conservation Treatment With Radiation: An Ongoing Success Story J. Clin. Oncol., February 10, 2010; 28(5): 709 - 711. [Full Text] [PDF]

				J. Zakhireh, B. Fowble, and L. J. Esserman Application of Screening Principles to the Reconstructed Breast J. Clin. Oncol., January 1, 2010; 28(1): 173 - 180. [Abstract] [Full Text] [PDF]

				J. E. Garber and M. Golshan Contralateral Breast Cancer in BRCA1/BRCA2 Mutation Carriers: The Story of the Other Side J. Clin. Oncol., December 10, 2009; 27(35): 5862 - 5864. [Full Text] [PDF]

				M. M. Mohiuddin and W. F. Regine Consenting the Patient With Early-Stage Breast Cancer: "Informed" Only After Multi-Discliplinary Evaluation J. Clin. Oncol., October 20, 2009; 27(30): e158 - e159. [Full Text] [PDF]

				M. Morrow, R. Jagsi, A. K. Alderman, J. J. Griggs, S. T. Hawley, A. S. Hamilton, J. J. Graff, and S. J. Katz Surgeon Recommendations and Receipt of Mastectomy for Treatment of Breast Cancer JAMA, October 14, 2009; 302(14): 1551 - 1556. [Abstract] [Full Text] [PDF]

				R. Katipamula, A. C. Degnim, T. Hoskin, J. C. Boughey, C. Loprinzi, C. S. Grant, K. R. Brandt, S. Pruthi, C. G. Chute, J. E. Olson, et al. Trends in Mastectomy Rates at the Mayo Clinic Rochester: Effect of Surgical Year and Preoperative Magnetic Resonance Imaging J. Clin. Oncol., September 1, 2009; 27(25): 4082 - 4088. [Abstract] [Full Text] [PDF]

				M. Morrow and J. R. Harris More Mastectomies: Is This What Patients Really Want? J. Clin. Oncol., September 1, 2009; 27(25): 4038 - 4040. [Full Text] [PDF]

				T. M. Tuttle, S. Jarosek, E. B. Habermann, A. Arrington, A. Abraham, T. J. Morris, and B. A. Virnig Increasing Rates of Contralateral Prophylactic Mastectomy Among Patients With Ductal Carcinoma In Situ J. Clin. Oncol., March 20, 2009; 27(9): 1362 - 1367. [Abstract] [Full Text] [PDF]

				A. Recht Contralateral Prophylactic Mastectomy: Caveat Emptor J. Clin. Oncol., March 20, 2009; 27(9): 1347 - 1349. [Full Text] [PDF]

				D. H. Roukos, E. Lykoudis, and T. Liakakos Genomics and Challenges Toward Personalized Breast Cancer Local Control J. Clin. Oncol., September 10, 2008; 26(26): 4360 - 4361. [Full Text] [PDF]

				E. Briasoulis and D. H. Roukos Contralateral Prophylactic Mastectomy: Mind the Genetics J. Clin. Oncol., April 10, 2008; 26(11): 1909 - 1910. [Full Text] [PDF]

				T. M. Tuttle, E. B. Habermann, and B. A. Virnig In Reply J. Clin. Oncol., April 10, 2008; 26(11): 1910 - 1910. [Full Text] [PDF]

				More Breast Cancer Patients Choosing Contralateral Prophylactic Mastectomy Journal Watch Women's Health, December 6, 2007; 2007(1206): 2 - 2. [Full Text]