Contralateral Prophylactic Mastectomy Use On The Rise

Rate increased among women with unilateral ductal carcinoma in situ from 1998 to 2005
By Eric Metcalf
HealthDay Reporter

FRIDAY, Feb. 20 (HealthDay News) -- During recent years, contralateral prophylactic mastectomy has become a more commonly used treatment in women with ductal carcinoma in situ, according to research published online Feb. 17 in the Journal of Clinical Oncology.

Todd M. Tuttle, M.D., of the University of Minnesota, Minneapolis, and colleagues analyzed data from the Surveillance, Epidemiology and End Results database on 51,030 women diagnosed with unilateral ductal carcinoma in situ (DCIS) from 1998 to 2005 who were treated with surgery.

Most patients were treated with breast-conserving surgery (69.9 percent) or unilateral mastectomy (26.1 percent). However, 4.1 percent underwent contralateral prophylactic mastectomy (CPM). Over this time period, the rate of CPM rose by 148 percent among all surgically treated women, and by 188 percent among women undergoing mastectomy, excluding breast-conserving surgery. Among all surgically treated patients, factors associated with higher CPM rates included younger age, large tumor size and higher grade.

"Many factors probably contribute to the increased use of CPM for DCIS. The availability of genetic counseling and BRCA testing has increased in recent years. Improvement in mastectomy and breast reconstruction techniques may also partially explain increased CPM rates. Also, because obesity rates have increased in recent years in the United States, obese women may choose to undergo CPM to achieve balance and symmetry. The increased use of breast MRI may contribute to rising CPM rates," the authors write.

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