ASO Author Reflections: Contralateral Prophylactic Mastectomy—Moving Beyond Sociodemographic Factors

Excerpt

The adoption of widespread mammography screening has resulted in a significant increase in the incidence of ductal carcinoma in situ (DCIS).1 Lack of clinicopathologic criteria to effectively risk stratify DCIS lesions has led to significant controversy regarding clinical management and possibly overtreatment. Studies have demonstrated a significant increase in the use of contralateral prophylactic mastectomy (CPM) in the management of DCIS, without any improvement in overall survival.2 In assessing the predictors of CPM use, many studies have focused on sociodemographic factors. These studies consistently show that younger, Caucasian women of higher socioeconomic strata are more likely to undergo CPM. Assessment of the clinical, pathologic, and patient factors that influence the selection of CPM is important in guiding clinical decision making. Less attention has been given to other factors, which may impact treatment choice. More importantly, there is a paucity of data in the literature regarding treatment trends in non-Caucasian women. …