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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2024

23-01-2024 | Mastectomy | Breast Oncology

Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks

Authors: Puneet Singh, MD, MS, Doreen Agnese, MD, Miral Amin, MD, Andrea V. Barrio, MD, Astrid Botty Van den Bruele, MD, Erin Burke, MD, David N. Danforth Jr., MD, Frederick M. Dirbas, MD, Firas Eladoumikdachi, MD, Olga Kantor, MD, Shicha Kumar, MD, Marie Catherine Lee, MD, Cindy Matsen, MD, Toan T. Nguyen, MD, Tolga Ozmen, MD, Ko Un Park, MD, Jennifer K. Plichta, MD, MS, Chantal Reyna, MD, Shayna L. Showalter, MD, Toncred Styblo, MD, Nicholas Tranakas, MD, Anna Weiss, MD, Christine Laronga, MD, Judy Boughey, MD

Published in: Annals of Surgical Oncology | Issue 4/2024

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Abstract

Rates of contralateral mastectomy (CM) among patients with unilateral breast cancer have been increasing in the United States. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, risks, and benefits of CM since the society’s 2017 statement. We held a virtual meeting to outline key topics and then conducted a literature search using PubMed to identify relevant articles. We reviewed the articles and made recommendations based on group consensus. Patients consider CM for many reasons, including concerns regarding the risk of contralateral breast cancer (CBC), desire for improved cosmesis and symmetry, and preferences to avoid ongoing screening, whereas surgeons primarily consider CBC risk when making a recommendation for CM. For patients with a high risk of CBC, CM reduces the risk of new breast cancer, however it is not known to convey an overall survival benefit. Studies evaluating patient satisfaction with CM and reconstruction have yielded mixed results. Imaging with mammography within 12 months before CM is recommended, but routine preoperative breast magnetic resonance imaging is not; there is also no evidence to support routine postmastectomy imaging surveillance. Because the likelihood of identifying an occult malignancy during CM is low, routine sentinel lymph node surgery is not recommended. Data on the rates of postoperative complications are conflicting, and such complications may not be directly related to CM. Adjuvant therapy delays due to complications have not been reported. Surgeons can reduce CM rates by encouraging shared decision making and informed discussions incorporating patient preferences.
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Metadata
Title
Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks
Authors
Puneet Singh, MD, MS
Doreen Agnese, MD
Miral Amin, MD
Andrea V. Barrio, MD
Astrid Botty Van den Bruele, MD
Erin Burke, MD
David N. Danforth Jr., MD
Frederick M. Dirbas, MD
Firas Eladoumikdachi, MD
Olga Kantor, MD
Shicha Kumar, MD
Marie Catherine Lee, MD
Cindy Matsen, MD
Toan T. Nguyen, MD
Tolga Ozmen, MD
Ko Un Park, MD
Jennifer K. Plichta, MD, MS
Chantal Reyna, MD
Shayna L. Showalter, MD
Toncred Styblo, MD
Nicholas Tranakas, MD
Anna Weiss, MD
Christine Laronga, MD
Judy Boughey, MD
Publication date
23-01-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-14893-x

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