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

Details

• Personal Author:
  Grund EH ; Habermann EB ; Morris TJ ; Tuttle TM ; Virnig BA
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Biochemistry Delivery Of Health Care Environmental Monitoring Epidemiology Health Care Facilities Workforce And Services Neoplasms Occupational Health Preventive Medicine Safety Safety Management
• Keywords:
  Biochemical-analysis Biological-effects Breast-cancer Cancer-rates Disease-incidence Exposure-assessment Health-care Health-services Medical-care Medical-treatment Preventive-medicine Prophylaxis Quantitative-analysis Safety-measures Statistical-analysis Surgery

  More +
• ISSN:
  0732-183X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Minnesota ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  25
• Issue:
  33
• NIOSHTIC Number:
  nn:20037545
• Citation:
  J Clin Oncol 2007 Nov; 25(33):5203-5209
• Contact Point Address:
  Todd M. Tuttle, MD, University of Minnesota, Department of Surgery, Division of Surgical Oncology, 420 Delaware St SE, Minneapolis, MN
• Email:
  tuttl006@umn.edu
• Federal Fiscal Year:
  2008
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Clinical Oncology
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:875528793e114b15708ed09512ac48f1a8b423285c91ed9c35c07a54e455b5a5a521ae572f7858ecb5852e7a0b8a1aa57dbda79a3f400f8990d1a1dee37b4177
• Download URL:
  https://stacks.cdc.gov/view/cdc/188622/cdc_188622_DS1.pdf
• File Type:
  [PDF - 113.44 KB ]