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Published in: Annals of Surgical Oncology 8/2023

21-01-2023 | Mastectomy | Breast Oncology

Survival Outcomes in Women with Unilateral, Triple-Negative, Breast Cancer Correlated with Contralateral Prophylactic Mastectomy

Authors: Genevieve A. Fasano, MD, Solange Bayard, MD, Yalei Chen, PhD, Jennifer Marti, MD, Rache Simmons, MD, Alexander Swistel, MD, Jessica Bensenhaver, MD, Melissa Davis, PhD, Lisa Newman, MD, MPH

Published in: Annals of Surgical Oncology | Issue 8/2023

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Abstract

Background

Despite increased utilization of contralateral prophylactic mastectomy (CPM), there is insufficient evidence that it improves survival in average-risk women with unilateral breast cancer. CPM may be of heightened interest to patients with triple negative breast cancer (TNBC) because these patients are more likely to have BRCA1 mutation-associated disease and are not candidates for the chemoprevention benefits of adjuvant endocrine therapy.

Methods

Survival and recurrence outcomes were evaluated for all TNBC patients from a multi-institutional database (1999–2018) at two academic cancer programs in two metropolitan cities of the Northeast and Midwest. Median follow-up time was 3.7 years.

Results

Seven hundred and nighty six TNBC patients were evaluated and 15.45% underwent CPM. Women undergoing CPM were more likely to be white (p < 0.001), younger (p < 0.001), and underwent genetic testing (p < 0.001). A borderline survival benefit was observed for TNBC patients undergoing CPM (5-year overall survival 95.1% vs. 85.0%; p = 0.05). There was no difference in survival when BRCA mutation carriers were excluded (5-year overall survival 94.1% vs. 85.2%; p = 0.12). For BRCA mutation carriers, a numeric trend was observed for improved survival for patients undergoing CPM (5-year overall survival 97.2% vs. 84.1%; p = 0.35). Among patients not undergoing CPM, the rate of developing a new primary breast cancer was 2.2% (15/673). Among these 15 patients, 20% (3/15) were known BRCA mutation carriers.

Conclusions

Our data demonstrate no survival benefit for TNBC patients without BRCA1/2 mutations undergoing CPM.
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Metadata
Title
Survival Outcomes in Women with Unilateral, Triple-Negative, Breast Cancer Correlated with Contralateral Prophylactic Mastectomy
Authors
Genevieve A. Fasano, MD
Solange Bayard, MD
Yalei Chen, PhD
Jennifer Marti, MD
Rache Simmons, MD
Alexander Swistel, MD
Jessica Bensenhaver, MD
Melissa Davis, PhD
Lisa Newman, MD, MPH
Publication date
21-01-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-13056-0

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