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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2010

01-10-2010 | Breast Oncology

Contralateral Prophylactic Mastectomy is Associated with a Survival Advantage in High-Risk Women with a Personal History of Breast Cancer

Authors: Judy C. Boughey, MD, Tanya L. Hoskin, MS, Amy C. Degnim, MD, Thomas A. Sellers, PhD, Joanne L. Johnson, RN, Melanie J. Kasner, LPN, Lynn C. Hartmann, MD, Marlene H. Frost, PhD

Published in: Annals of Surgical Oncology | Issue 10/2010

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Abstract

Background

The aim of this study was to investigate whether contralateral prophylactic mastectomy (CPM) in addition to therapeutic mastectomy (TM) is associated with a survival advantage in high-risk women with breast cancer.

Methods

A total of 385 women with stage I or II breast cancer and a family history of breast cancer who underwent TM and CPM between 1971 and 1993 were evaluated and compared to 385 patients matched on age at diagnosis, tumor stage, nodal status, and year of diagnosis who underwent TM-only. Contralateral breast cancer (CBC) events and survival outcomes were compared.

Results

At a median follow-up of 17.3 years, 2 CBCs (0.5%) developed in the CPM cohort and 31 (8.1%) in the TM-only cohort, representing a 95% decreased risk of CBC (hazard ratio [HR] = 0.05, 95% confidence interval [95% CI] 0.01–0.22, P < 0.0001). One hundred twenty-eight women in the CPM group and 162 women in the TM-only group have died, resulting in 10-year overall survival estimates of 83 and 74%, respectively (HR 0.68, 95% CI 0.54–0.86, P = 0.001). This difference in overall survival persisted in multivariate analysis (HR 0.77, P = 0.03). Disease-free survival (DFS) was better in the CPM cohort than the TM-only group (HR 0.66, 95% CI 0.53–0.82, P = 0.0002) and remained significant in multivariate analysis (HR 0.67, P = 0.0005).

Conclusions

In this retrospective cohort study, CPM was associated with decreased CBC event and improved overall survival and disease free survival.
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Metadata
Title
Contralateral Prophylactic Mastectomy is Associated with a Survival Advantage in High-Risk Women with a Personal History of Breast Cancer
Authors
Judy C. Boughey, MD
Tanya L. Hoskin, MS
Amy C. Degnim, MD
Thomas A. Sellers, PhD
Joanne L. Johnson, RN
Melanie J. Kasner, LPN
Lynn C. Hartmann, MD
Marlene H. Frost, PhD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1136-7

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