View Entire Collection
By Clinical Topic
By State Requirement
Diabetes – Summer 2012
Future of Nursing Initiative
Heart Failure - Fall 2011
Influenza - Winter 2011
Nursing Ethics - Fall 2011
Trauma - Fall 2010
Traumatic Brain Injury - Fall 2010
Fluids & Electrolytes
Women facing an early-stage breast cancer diagnosis may elect to have a contralateral prophylactic mastectomy (CPM) to reduce the risk of developing a contralateral breast cancer. In the United States, CPM rates for all surgically treated women with stages I through III unilateral breast cancer increased dramatically from 1998 to 2003. In 1991, the National Institutes of Health Consensus Panel concluded that breast-conserving surgery is an appropriate and preferred treatment for the majority of women with stage I and II breast cancer because it provides survival rates equivalent to those of total mastectomy while preserving the breast. Owing to the near equivalence of the 2 surgical treatment options in terms of survival benefit and recurrence risk, surgical treatment for early-stage breast cancer qualifies as a "preference-sensitive decision" for which no one treatment is best (S. T. Hawley, 2010; The Dartmouth Atlas of Health Care, 2010). We performed a literature review to identify studies that examined CPM decision making in women facing an early-stage breast cancer diagnosis with the aim of determining the most influential factors affecting her surgical choice. Study outcome measures were largely based on demographic information retrospectively extracted from large databases representing trends rather than revealing influences reflecting preference-sensitive decision making. While we may know demographically, which women choose CPM, we do not know why. To better understand this increasing trend, which greatly impacts patient counseling, prospective research is needed using decision quality methods developed to illuminate factors influencing a woman's decision.
Breast cancer is the most common malignancy in women and second only to lung cancer as the cause of cancer-related deaths among women in North America and Western Europe. The incidence of breast cancer is increasing, although survival also appears to be increasing (Lostumbo, Carbine, & Wallace, 2010). In 2012, in the United States, 226,870 new cases and 39,510 deaths from breast cancer are estimated. In addition to invasive breast cancer, 63,300 new cases of in situ breast cancer are expected to occur. Of these, approximately 85% will be ductal carcinoma in situ (DCIS; American Cancer Society, 2013).
Women diagnosed with breast cancer have a significantly increased lifetime risk of developing a cancer in the contralateral breast over the general population. Gao, Fisher, and Emami (2003) evaluated the incidence of contralateral breast cancer (CBC) in 134,501 women previously diagnosed with breast cancer and found that the actuarial incidence of CBC at 5, 10, 15, and 20 years was 3%, 6.1%, 9.1%, and 12%, respectively, or approximately 0.6% per year.
Recent progress in using molecular methods to understand the genetic basis of certain cancers has led to increased interest in predicting breast cancer and identifying higher-risk women who may be particularly interested in preventing or reducing that risk (Lostumbo et al., 2010). Women diagnosed with a unilateral breast cancer and thus at higher risk of developing a primary CBC may consider contralateral prophylactic mastectomy (CPM) to prevent a second occurrence.
Contralateral prophylactic mastectomy rates for all surgically treated women with stages I through III unilateral breast cancer increased by 150% from 1998 to 2003 (Tuttle, Habermann, Grund, Morris, & Virnig, 2007). The rate of CPM in women with DCIS increased by 148% in the United States from 1998 to 2005 (Tuttle et al., 2009) and rates continued to increase through 2006 with no plateau effect (Tuttle, Abbott, Arrington, & Rueth, 2010). In a retrospective study, Yi et al. (2010) found that at their institution the proportion of women who chose CPM increased significantly from 6.8% in 2000 to 14.0% in 2006 (a 105% increase (P < .0001).
The annual risk of metachronous development of clinically detected CBC is about 0.6%. While the annual risk is constant, follow-ups indicate that the cumulative risk increases; thus, CBC occurrence is clinically more significant in patients likely to survive for a long time (Tuttle et al., 2010). Women with unilateral breast cancer have approximately three to five times higher risk of developing CBC than women without breast cancer; women with a family history of breast cancer have an even higher risk (Gao et al., 2003). For women who have germ-line BRCA1/2 mutations, the annual risk for CBC is approximately 3%, 40% at 10 years with the overall risk as high as 52% by age 70 years, or lifetime risk of 40%-65% (Metcalfe et al., 2004) and for whom the potential benefit of CPM is greatest. It is known that moderate- to high-risk histologies, such as atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ (LCIS), also confer an increased risk for developing breast cancer (Montgomery et al., 1999). Using the Surveillance, Epidemiology, and End Results (SEER) database of 18,845 patients with DCIS, Gao et al. (2003) reported that CBC risk increased with time: the 10- and 20-year actuarial rate 6.1% and 12%, respectively.
Clinical and pathologic factors associated with an increased risk of developing CBC include age less than 50 years, lobular-type histology, multicentric cancer, and previous chest irradiation. Additional risk factors identified include African-American ethnicity, body mass index greater than 30, medullary carcinoma histology, and HER2-positive tumors (Gao et al., 2003; Li, Malone, Porter, & Daling, 2003). However, the most important predictor of CBC development is a personal history of breast cancer (Montgomery et al., 1999).
The incidence of clinically or pathologically detected synchronous CBC is about 3%-5%. In the American College of Radiology Imaging Network magnetic resonance imaging (MRI) study (Tuttle et al., 2007), about 3% of women had occult CBC identified by MRI. In 239 women with unilateral breast cancer who underwent CPM, Goldflam et al. (2004) reported that occult cancer (infiltrating lobular, infiltrating ductal, or DCIS) was identified in 4.6% of CPM specimens, and moderate- to high-risk pathology (LCIS, atypical lobular hyperplasia, or atypical ductal hyperplasia) was identified in 18.4% of CPM specimens. In a more recent study to identify factors predicting occult malignancy or high-risk lesions in the contralateral breast among 407 women undergoing CPM, King et al. (2011a) reported that occult CBC was identified in 24 patients, and 114 (28%) had a high-risk lesion.
Contralateral prophylactic mastectomy nearly eliminates a woman's risk of developing CBC; however, it is much less clear whether or by how much CPM improves long-term breast-cancer-specific survival rates (Lostumbo et al., 2010). This benefit would be more likely for women with proven BRCA1 or BRCA2 mutations, whose risk (without intervention) of developing CBC is 35% and 45%, respectively, at 10 years (Metcalfe et al., 2004) and for whom the decision path toward CPM may be clearer.
After a unilateral breast cancer diagnosis, the incidence of metachronous CBC has been reported to range from 0.7% to 1.8% per person-years. The efficacy of CPM in preventing CBC occurrence has been demonstrated in several studies. In a study of 745 patients with primary breast cancer and family history of breast or ovarian cancer, McDonnell et al. (2001) reported that CPM reduced the incidence of CBC by 94% at a median follow-up period of 10 years. In a cohort of female BRCA1 or BRCA2 mutation carriers previously treated for unilateral invasive breast cancer stages I-IIIa, van Sprundel et al. (2005) reported that CPM reduced the risk of CBC by 91%, independent of the impact of bilateral prophylactic oophorectomy. The effectiveness of CPM in preventing breast-cancer mortality, however, remains controversial. In a 2010 Cochrane review (Lostumbo et al., 2010) of 39 retrospective studies on 7,384 women with a wide range of risk factors who underwent prophylactic mastectomy, the authors concluded that CPM studies consistently reported reductions in the incidence of CBC but noted insufficient evidence that disease-specific survival improves. However, in patients with early-stage (0, I, II) breast cancer, who underwent unilateral mastectomy and in whom risk factors for CBC were present, Peralta et al. (2000) found that disease-free survival at 15 years in the CPM group was significantly improved at 55% (95% confidence interval [CI]: 38%-69%) versus 28% (95% CI: 19%-36%) in the control group (P = .01). A trend toward improved overall survival was seen in the CPM group of 71% (95% CI: 52%-84%) versus 53% (95% CI: 42%-62%) in the control group (P = .06). In addition, a 2005 Cancer Network Research project (Herrinton et al., 2005) reported a 97% decrease in incidence of CBC and a 43% (3.7% absolute) (hazard ratio for death = 0.57, 95% CI = 0.45-0.72) reduction in breast cancer mortality among higher risk women who opted for CPM.
Although the absolute indications for CPM are not clearly defined, the Society of Surgical Oncology provides a position statement outlining potential indications for CPM, including risk reduction in women with higher-risk BRCA mutations or other genetic susceptibility genes, history in multiple first-degree relatives with no demonstrable mutation, atypical ductal or lobular hyperplasia, or LCIS histology, difficult mammographic surveillance due to dense tissue or microcalcification, and comesis (for improved symmetry in patients undergoing mastectomy with reconstruction for the index cancer). This position statement was developed in 1993 to guide insurance programs in determining coverage and to help patients obtain reimbursement (Giuliano et al., 2007).
In 1991, the National Institutes of Health (1991) issued a consensus statement advocating breast-conserving surgery (BCS) as the preferred surgical treatment for early-stage breast cancer, a recommendation resting on survival rates being equivalent. However, all modern prospective randomized, controlled trials comparing BCS with mastectomy demonstrate a modest but increased risk of local recurrence in the BCS arm of about 1% per year (King, 2011).
Alternatives to CPM include surveillance with clinical examination, mammography, MRI, and chemoprevention. Adjuvant endocrine therapy is known to decrease CBC risk by 50%, a reduction more pronounced among women receiving aromatase inhibitors (Fisher et al., 1996). In the National Surgical Adjuvant Breast and Bowel Project P-1 Study (Fisher et al., 1998), which included higher risk women with a history of LCIS, tamoxifen decreased the incidence of breast cancer by 49%, but only in estrogen-receptor-positive tumors; there was no impact on the incidence of estrogen-receptor-negative tumors. Tamoxifen use in high-risk postmenopausal women, however, is associated with an increase in endometrial cancer risk and thromboembolic events, such as deep vein thrombosis and pulmonary embolism. Tamoxifen may also cause or exacerbate vasomotor symptoms (hot flashes, cold sweats) and vaginal discharge or itching in women of all ages (Newman et al., 2000); side effects women may wish to avoid.
It is unclear precisely what influences a woman's decision to undergo CPM. Based on retrospective studies, however, many clinical management factors are thought to potentiate the decision-making process, among them, increased awareness of genetic factors in breast cancer, improved mastectomy and reconstruction techniques, increased utilization of breast MRI, and changing perception of the importance of breast-conserving treatment (including radiation) (Habermann et al., 2010). Other important factors include younger age, family history, and psychologic factors such as anxiety and stress. When considering the psychologic effects (anxiety, stress, uncertainty) of heightened surveillance and physiologic discomforts of chemoprevention on quality of life related to BCS, CPM may be chosen as a more acceptable treatment option.
A comprehensive literature review was obtained through online and manual searches of PubMed, CINHAL, PsycINFO, Cochrane database, and bibliographic review of articles published between 1998 and 2011 (the period of reported CPM increases), based on title and abstract relevance to CPM identified by the searches. The selection criteria were (1) primary studies of women with early stage 0-II (including stage III). primary unilateral breast cancer, DCIS without evidence of a CBC, and who were BCS eligible; (2) studies conducted in the United States and Canada; and (3) reports on comparative factors influencing CPM as the choice of treatment.
Contralateral prophylactic mastectomy decision-making may be clearer for women who are BRCA positive; therefore, we considered mainly those studies focusing on the decision-making process for women who were BRCA1/2 negative or of unknown status. One study was included that researched CPM decision making in newly diagnosed women with early-stage breast cancer that were offered BRCA testing prior to receipt of treatment. This study was relevant because of the significant number of BRCA1/2-negative women along with the test decliners who chose to undergo CPM.
Nine relevant U.S. studies (eight retrospective and one prospective) were identified and reviewed and are summarized in Table 1. Eight were published within the past 9 years; one was dated 1998. Quantitative data were collected on women with unilateral breast cancer receiving CPM from 1960 through 2009. All studies used one or more of the following: patient demographics, tumor characteristics, or clinical management factors in establishing predictors, and compared CPM receipt to other criteria including unilateral mastectomy, adherence to professional guidelines, surgeon characteristics, presurgical genetic testing, and reconstruction.
The studies largely were based on information extracted retrospectively using site-specific surgery codes from national databases (SEER, National Comprehensive Cancer Network database) and databases from leading cancer centers (the University of Texas M.D. Anderson Cancer Center, Memorial Sloan-Kettering Cancer Center, and Lombardi Cancer Center, Georgetown University). Other sources for data collection included hospital records and a study-specific questionnaire.
No quality studies were identified that specifically sought to investigate preference-sensitive decisions-patient-specific factors that influenced a woman's decision to undergo CPM. Such factors may reflect a woman's personal goals (minimizing the number of surgeries and time spent getting treatment or in recovery; returning to daily activities as soon as possible), concerns (fear of developing CBC and the temporary or long-term adverse health states possible after treatment associated with BCS), and values (impact on health-related quality of life [HRQOL] related to adjuvant therapies/treatments and their impact on family; the weight of doctor's or spouse's recommendation; Lee et al., 2010). Only one study, conducted by Han et al. (2011), using descriptive measures, sought to clarify the patients' goals and desired outcomes to understand their choice of surgical treatment; however, the study had considerable limitations inherent to a retrospective, survey-based study and a small sample size in the CPM group (n = 88). The factors associated with or as predictors of CPM receipt in the remaining studies reviewed here relate to patient demographics, tumor characteristics, and clinical management factors, which are outlined in Table 2.
Family history and/or past history of breast cancer was significantly associated with higher CPM rates. Young age was a significant factor in half of the studies reviewed, which is consistent with the most benefit derived as relates to a larger absolute lifetime risk of metachronous CBC.
Hoover, Paragi, Santoro, Schafer, and Chamberlain (2010) found that family history in one or more first-degree relatives was the most common indication for prophylactic mastectomy in 44 of 124 patients undergoing CPM. Results from a prior study by Gershenwald et al. (1998) also concluded strong family history as the most influential factor in choosing CPM along with immediate bilateral reconstruction. Approximately 82% of women had family history of breast or other primary cancer; 30% had at least one first-degree relative with breast cancer. It is known that family history of ovarian or colon cancer also increases the risk of CBC, and it is accepted that overall concern and fear of cancer may affect choices of treatment and follow-up (Gershenwald et al., 1998). It has been shown that in high-cancer-risk women, intrusive thoughts and worries may reduce compliance with recommended mammography screenings (Lerman et al., 1993). Some women may have difficulty in accepting heightened surveillance with repetitive imaging with mammography and MRI following diagnosis of the ipsilateral breast.
In the only prospective study, descriptive statistics were used to cite an association between patient characteristics and tumor characteristics. Schwartz et al. (2004) evaluated the impact of pretreatment genetic counseling and BRCA1/2 testing on decision making in 129 women newly diagnosed with DCIS to stage IIIa breast cancer. They found a significant impact on the decision to undergo CPM, despite a negative result. No recent studies were found that assess how a woman perceives the psychoemotional impact of BCS, radiation, heightened surveillance, and chemoprevention versus her perception of HRQOL following CPM. Fear of developing a CBC may significantly impact a woman's social relationships, affecting her quality of life, yet studies are lacking in this area.
Hoover et al. (2010) collected operative records of 124 women who underwent CPM at their medical center and analyzed the indications and possible decision-making process leading to prophylactic mastectomy (including CPM) evaluating adherence to the Society of Surgical Oncology and the National Cancer Institute guidelines. The authors acknowledged substantial psychologic factors (including one's body image and sense of self) that can strongly influence a woman's decision. While national databases that collect mainly demographic and statistical information usually do not contain these factors, their study extracted patient-specific concerns from the medical records. It was found that in 3 of the 44 women with unilateral breast cancer, having young children, wishing to avoid the stress of constant surveillance, and having recurrent benign breast disease with multiple negative biopsies in the opposite breast influenced the choice for CPM.
In the one study intended to evaluate the woman's rationale in having chosen unilateral or bilateral mastectomy or CPM, Han et al. (2011) developed a questionnaire that included write-in comments aimed at assessing outcome variables. The top reason for choosing CPM in this group was anxiety over future cancer and the desire to reduce its risk. This retrospective, survey-based study, however, was further limited by a small number of respondents (250 of 350) from a community health system tumor registry, and a study-specific survey that had not been tested.
In four studies, the tumor characteristics associated with significantly higher CPM rates included clinically higher tumor stage, multicentric primary tumor, invasive or in situ lobular histology, and recent diagnosis (Arrington, Jarosek, Virnig, Habermann, & Tuttle, 2009; Gershenwald et al., 1998; Tuttle et al., 2009;Yi et al., 2010). Tumor histology and family history were found to associate significantly with CPM receipt in over half the studies reviewed, suggesting women's concerns over both CBC and a recurrence of the primary cancer.
Results from the study conducted by King et al. (2011b) suggest that treatment factors such as repeated imaging (mammography and MRI), unsuccessful attempts at BCS, and immediate breast reconstruction were associated with choosing bilateral mastectomy. Eighty-one percent of study patients converted to CPM after a single attempt at excision of the primary lesion, which suggests that the need for multiple procedures (to obtain clear margins or treatment for cancer recurrence) may significantly impact the surgical decision-making process.
While the importance of patient preferences in medical decision making is widely recognized, the influence of a woman's preferences in breast cancer treatment choices has not been well documented (Sepucha, Ozanne, Silvia, Partride, & Mulley, 2007). Most of the reviewed studies-conducted retrospectively-have focused on statistical data from clinical management and patient demographics in an attempt to extract outcome variables or measures associated with or predictive of choosing CPM for newly diagnosed, early-stage breast cancer. Only one study, though significantly limited, sought to clarify a woman's unique, patient-specific goals and desired outcomes attempting to understand the rationale for her surgical choice.
Many women who have recently undergone a diagnostic workup for the primary cancer may wish to avoid the ongoing imaging and procedural biopsy that can characterize breast surveillance. Women's concerns may revolve more around an aversion toward the discomforts and risks related to surveillance of the unaffected breast, therapy for a future CBC, or cancer recurrence in the ipsilateral breast. The physical and psychologic risks associated with CPM (with or without reconstruction) may weigh less heavily (Kahn, 2011). Contralateral prophylactic mastectomy may be chosen as a more acceptable treatment option when considering the quality-of-life effects (anxiety, stress, uncertainty) of heightened surveillance. Also, of concern to women in surgical decision making are the adverse effects of radiation or the inconvenience of adding radiation to an already-complicated treatment regimen following BCS (Sepucha et al., 2007). No recent studies found compared the impacts of BCS and CPM on HRQOL for women with early-stage breast cancer, which are very real concerns.
It is important that women's preferences in treatment decision making be reflected in the guidelines for clinical management of early-stage breast cancer. These types of decisions reflect the fact that the medical evidence is necessary, but not sufficient. Patients' personal preferences are also necessary to make an appropriate decision (Wennberg, Fisher, & Skinner, 2002).
Studies using epidemiologic data sources such as the SEER database using patient characteristics including race, socioeconomics, family history of breast cancer, surgeon characteristics, such as gender or treatment recommendations, and clinical management factors such as difficult surveillance and improved reconstruction techniques offer insights into possible correlates with CPM decisions. Such studies demonstrate trends rather than revealing the actual influences a patient's personal values, concerns, and goals have in her perception of CPM's advantages (Collins et al., 2009). This literature review highlights the continuing lack of understanding regarding the motivations of patients newly diagnosed with breast cancer and the role of providers who interact with them during the initial crucial weeks of decision making already recognized by leading medical professionals (Kahn, 2011).
Prospective studies need to be conducted using decision-quality methods developed with the woman's patient-specific goals, values, and concerns as variables. Measuring patient-preference-sensitive decision making for CPM could be achieved through qualitative and quantitative investigations that employ interpretive methods to help clarify an individual's experience with newly diagnosed breast cancer as well as bring to light the most influential factors impacting her surgical treatment choice. Reliable and valid measures employed could include concerns regarding future CBC risk, avoidance/aversion of repetitive imaging with heightened surveillance following BCS, and the burden of the treatment experienced and its effect on HRQOL.
Quality decision making requires that patients be informed about treatment options, receive treatment that is consistent with their preferences and goals, and be involved in making decisions about their care (Sepucha, Floyd, & Mulley, 2004). The quality of a preference-sensitive clinical decision can be defined as the extent to which the implemented decision reflects the considered needs, values, and expressed preferences of a well-informed patient (Sepucha et al., 2007). A better understanding of the motivations and perceptions of women seeking bilateral mastectomy for unilateral disease will impact counseling strategies that could help strengthen the patient-provider partnership leading to quality treatment decision making based on women's personal preferences as well as theory and empirical data.
Arrington A. K., Jarosek S. L., Virnig B. A., Habermann E. B., Tuttle T. M. (2009). Patient and surgeon characteristics associated with increased use of contralateral prophylactic mastectomy in patients with breast cancer. Annals of Surgical Oncology, 16(10), 2697-2704. [Context Link]
Collins E. K., Moore C. P., Clay K. F., Kearing S. A., O'Connor A. M., Liewellyn-Thomas H. A., et al. (2009). Can women with early-stage breast cancer make an informed decision for mastectomy? Journal of Clinical Oncology, 27(4), 519-525. [Context Link]
The Dartmouth Atlas of Health Care. (2010). Preference-sensitive care: A Dartmouth Atlas project topic brief. Retrieved January 19, 2013, from http://www.dartmouthatlas.org/downloads/reports/preference_sensitive.pdf[Context Link]
Fisher B., Costantino J. P., Wickerham D. L., Redmond C. K., Kavanah M., Cronin W. M., et al. (1998). Tamoxifen for prevention of breast cancer; report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Journal of the National Cancer Institute, 90(18), 1371-1388. [Context Link]
Fisher B., Dignam J., Bryant J., DeCillis A., Lawrence-Wickerman D., Wolmark N., et al. (1996). Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors. Journal of the National Cancer Institute, 88(21), 1529-1542. [Context Link]
Gao X., Fisher S. G., Emami B. (2003). Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: A population-based study. International Journal of Radiation Oncology Biology Physics, 56(4), 1038-1045. [Context Link]
Gershenwald J. E., Hunt K. K., Kroll S. S., Ross M. I., Baldwin B. J., Feig B. W., et al. (1998). Synchronous elective contralateral mastectomy and immediate bilateral breast reconstruction in women with early-stage breast cancer. Annals of Surgical Oncology, 5(6), 529-538. [Context Link]
Giuliano A. E., Boolbol S., Degnim A., Kuerer H., Leitch A. M., Morrow M. (2007). Society of Surgical Oncology: position statement on prophylactic mastectomy. Approved by the Society of Surgical Oncology Executive Council, 2007. Annals of Surgical Oncology, 14(9), 2425-2427. [Context Link]
Goldflam K., Hunt K. K., Gershenwald J. E., Singletary S. E., Mirza N., Kuerer H. M., et al. (2004). Contralateral prophylactic mastectomy. Predictors of significant histologic findings. Cancer, 101(9), 1977-1986. [Context Link]
Habermann E. B., Abbott A., Parsons H. M., Virnig B. A., Al-Refaie W. B., Tuttle T. M. (2010). Are mastectomy rates really increasing in the United States? Journal of Clinical Oncology, 28(21), 3437-3441. [Context Link]
Han E., Johnson N., Glissmeyer M., Wagie R., Carey B., DelaMelena T., et al. (2011). Increasing incidence of bilateral mastectomies: The patient perspective. The American Journal of Surgery, 201(5), 615-618. [Context Link]
Hawley S. T. (2010). Involving patients in the decision-making process regarding breast cancer treatment: Implications for surgery utilization. Women's Health, 6(2), 161-164. [Context Link]
Herrinton L. J., Barlow W. E., Yu O., Geiger A. M., Elmore J. G., Barton M. B., et al. (2005). Efficacy of prophylactic mastectomy in women with unilateral breast cancer: A cancer research network project. Journal of Clinical Oncology, 23(19), 4275-4286. [Context Link]
Hoover D. J., Paragi P. R., Santoro E., Schafer S., Chamberlain R. S. (2010). Prophylactic mastectomy in high-risk patients: A practice-based review of the indications. Do we follow guidelines? Breast Disease, 31(1), 19-27. [Context Link]
Kahn S. A. (2011). Contralateral prophylactic mastectomy; what do we know and what do our patients know? Journal of Clinical Oncology, 29(16), 2132-2135. [Context Link]
King T. A. (2011). Selecting local therapy in the young breast cancer patient. Journal of Surgical Oncology, 103(4), 330-336. [Context Link]
King T. A., Gurevich I., Sakr R., Patil S., Stempel M., Morrow M. (2011a). Occult malignancy in patients undergoing contralateral prophylactic mastectomy. Annals of Surgery, 254(1), 2-9. [Context Link]
King T. A., Sakr R., Patil S., Gurevich I., Stempel M., Sampson M., et al. (2011b). Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. Journal of Clinical Oncology, 29(16), 2158-2164. [Context Link]
Lee C. N., Dominik R., Levin C. A., Barry M. J., Cosenza C., O'Connor A. M. (2010). Development of instruments to measure the quality of breast cancer treatment decisions. Health Expectations, 13(3), 258-272. [Context Link]
Lerman C., Daly M., Sands C., Balshem A., Lustbader E., Heggan T., et al. (1993). Mammography adherence and psychological distress among women at risk for breast cancer. Journal of the National Cancer Institute, 85(13), 1074-1080. [Context Link]
Li C., Malone K. E., Porter P. L., Daling J. R. (2003). Epidemiologic and molecular risk factors for contralateral breast cancer among young women. British Journal of Cancer, 89(3), 513-518. [Context Link]
Lostumbo L., Carbine N. E., Wallace J. (2010). Prophylactic mastectomy for the prevention of breast cancer. Cochrane DB Systems Review, (11), CD002748. [Context Link]
McDonnell S. K., Schaid D. J., Myers J. L., Grant C. S., Donohue J. H., Woods J. E., et al. (2001). Efficacy of contralateral prophylactic mastectomy in women with a personal and family history of breast cancer. Journal of Clinical Oncology, 19(19), 3938-3943. [Context Link]
Metcalfe K., Lynch H. T., Ghadirian P., Tung N., Olivotto I., Warner E., et al. (2004). Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. Journal of Clinical Oncology, 22(12), 2328-2335. [Context Link]
Montgomery L. L., Tran K. N., Heelan M. C., Van Zee K. J., Massie J. J., Payne D. K., et al. (1999). Issues of regret in women with contralateral prophylactic mastectomies. Annals of Surgical Oncology, 6(6), 546-552. [Context Link]
American Cancer Society (2013). Cancer Facts & Figures 2013 Atlanta, GA: Author. [Context Link]
National Institutes of Health Consensus Development Conference: Treatment of early-stage breast cancer. (1991). Journal of the American Medical Association, 265(3), 391-395.
Newman L. A., Kuerer H. M., Hunt K. K., Vlastos G., Ames F. C., Ross M. I., et al. (2000). Prophylactic mastectomy. Journal of the American College of Surgery, 191(3), 322-330. [Context Link]
Peralta E. A., Ellenhorn J. D. K., Wagman L. D., Dagis A., Andersen J. S., Chu D. Z. J. (2000). Contralateral prophylactic mastectomy improves the outcome of selected patients undergoing mastectomy for breast cancer. The American Journal of Surgery, 180(6), 439-445. [Context Link]
Schwartz M. D., Lerman C., Brogan B., Peshkin B. N., Halbert C. H., DeMarco T., et al. (2004). Impact of BRCA1/BRCA2 counseling and testing on newly diagnosed breast cancer patients. Journal of Clinical Oncology, 22(10), 1823-1829. [Context Link]
Sepucha K. R., Floyd F. J., Mulley A. G. (2004). Policy support for patient-centered care: The need for measurable improvements in decision quality. Health Affairs, (Suppl Variation), VAR54-62. doi:10.1377/hlthaff.var.54 [Context Link]
Sepucha K., Ozanne E., Silvia K., Partride A., Mulley A. G. Jr. (2007). An approach to measuring the quality of breast cancer decisions. Patient Education and Counseling, 65, 261-269. [Context Link]
Tuttle T. M., Abbott A., Arrington A., Rueth N. (2010). The increasing use of prophylactic mastectomy in the prevention of breast cancer. Current Oncology Report, 12(1), 16-21. [Context Link]
Tuttle T. M., Habermann E. B., Grund E. H., Morris T. J., Virnig B. A. (2007). Increasing use of contralateral prophylactic mastectomy for breast cancer patients: A trend toward more aggressive surgical treatment. Journal of Clinical Oncology, 25(33), 5203-5209. [Context Link]
Tuttle T. M., Jarosek S., Habermann E. B., Arrington A., Abraham A., Morris T. J., et al. (2009). Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. Journal of Clinical Oncology, 27(9), 1362-1367. [Context Link]
van Sprundel T. C., Schmidt M. K., Rookus M. A., Brohet R., van Asperen C. J., Rutgers E. J., et al. (2005). Risk reduction of contralateral breast cancer and survival after contralateral prophylactic mastectomy in BRCA1 or BRCA2 mutation carriers. British Journal of Cancer, 93, 287-292. [Context Link]
Wennberg J., Fisher E., Skinner J. (2002). Geography and the debate over Medicare reform. Health Affairs, W96-W114. [Context Link]
Yi M., Hunt K. K., Arun B. K., Bedrosian I., Barrera A. G., Do K., et al. (2010). Factors affecting the decision of breast cancer patients to undergo contralateral prophylactic mastectomy. Cancer Prevention Research, 3(8), 1026-1034. [Context Link]
Back to Top