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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2019

01-08-2019 | Mastectomy | Epidemiology

The use of contralateral prophylactic mastectomy among elderly patients in the United States

Authors: Schelomo Marmor, Ariella M. Altman, William T. Mayleben, Jane Y. C. Hui, Jason W. Denbo, Eric H. Jensen, Todd M. Tuttle

Published in: Breast Cancer Research and Treatment | Issue 1/2019

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Abstract

Purpose

Previous studies have reported increased rates of contralateral prophylactic mastectomy (CPM) in the United States among women with unilateral breast cancer. These trends have primarily focused on younger breast cancer patients. Given the growing aging population in the United States, we sought to determine whether CPM use is also increasing in elderly patients.

Methods

This population-based study identified patients in the surveillance epidemiology and end results (SEER) data. We determined the rate of CPM as a proportion of all surgically treated patients and as a proportion of all mastectomies. We compared the unadjusted CPM rates over the study period using the Cochrane-Armitage test for trend. We used a logistic regression model to test for the factors associated with CPM utilization.

Results

We identified 261,281 patients ≥ 65 years who underwent surgical treatment for breast cancer. For all patients treated with surgery for invasive breast cancer, the use of CPM increased from 1 in 2004 to 3% in 2014 (200% increase). Among mastectomy patients, the use of CPM increased from 3 in 2004 to 7% in 2014 (133% increase). Young age, non-Hispanic white race, lobular histology, higher grade, increased stage, negative lymph node status, and recent year of diagnosis were significantly associated with increased CPM rates.

Conclusions

For elderly patients the use of CPM has continued to increase in the United States. These observations warrant concern in light of increasing evidence that CPM does not improve oncological outcomes and is associated with increased morbidity in older patients.
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Metadata
Title
The use of contralateral prophylactic mastectomy among elderly patients in the United States
Authors
Schelomo Marmor
Ariella M. Altman
William T. Mayleben
Jane Y. C. Hui
Jason W. Denbo
Eric H. Jensen
Todd M. Tuttle
Publication date
01-08-2019
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-019-05288-8

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