Navigation Links
Contralateral prophylactic mastectomy offers limited gains for breast cancer patients
Date:12/7/2011

(SAN ANTONIO, Texas) -- Contralateral prophylactic mastectomy (CPM), a procedure that removes the unaffected breast in patients with cancer in one breast, provides only a modest increase in life expectancy, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania. In fact, the study shows that the surgery may actually reduce the quality-adjusted life expectancy a measure of life expectancy that takes into account quality of life among women whose breast cancer is not hereditary. Since only around 10% of breast cancers are known to be caused by genetic factors, the findings of the study apply to the vast majority of women diagnosed with breast cancer who are treated with mastectomy.

The findings of the study will be reported on Wednesday, Dec. 7 at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. Using a computer-based decision analysis, researchers examined the impact of CPM on life expectancy and quality-adjusted life expectancy among groups of women with newly diagnosed unilateral breast cancer and no known genetic predisposition to the disease. Studies show that among these patients, there has been a 150 percent increase in this type of surgery in recent years.

The authors hope the findings will assist patients and physicians in making informed decisions about treatment strategies, based on a clear understanding of the actual benefits and risks involved in preventive mastectomies, and the potential for the surgery to have an adverse impact on women's quality of life.

"We suspect that many of the women who elect to undergo CPM are acting on the belief the surgery will substantially reduce their overall risk of dying of breast cancer," said senior author Robert G. Prosnitz, MD, MPH, an assistant professor of Radiation Oncology in the Perelman School of Medicine at the University of Pennsylvania. "However, our study shows that a woman's risk of death from her primary breast cancer far outweighs her risk of death from a potential breast cancer developing in the unaffected breast. Additionally, the modest increase in life expectancy resulting from CPM may ultimately be negated by a reduction in quality of life."

The study showed that CPM produced modest gains in life expectancy in all subjects, regardless of the stage or subtype of the cancer. The greatest life expectancy gain from electing to have the procedure was seen in younger women with early-stage cancers whose type is known to carry a favorable prognosis. Even in these patients, however, the risk of death from their primary breast cancer far exceeded the risk of death from a breast cancer that may later develop on the opposite side. In these types of patients who forego CPM, for example, the study found that the risk of death from the primary breast cancer within 20 years was 10 times higher than the risk of death from a breast cancer that might later arise on the unaffected side.

Additional results of the study showed that CPM may actually reduce the quality-adjusted life expectancy for patients with unilateral breast cancers not linked to genetic factors. Because CPM is associated with both short and long-term effects that may reduce quality of life, the researchers used a model that took into account those issues. If CPM is assumed to cause even a small reduction in quality of life - due to surgical complications, loss of sensation in the breast, etc the results indicate that not undergoing this procedure is the preferred strategy for all patients, regardless of age, cancer stage or tumor molecular subtype.

Based on the findings, Prosnitz and his colleagues plan to develop and test decision aids that will help patients better assess their treatment options.

"At the outset of the study, we already knew that CPM was not going to help women with locally advanced breast cancers," said Prosnitz. "What surprised us, however, was how small the benefits were for women with even the most favorable breast cancers."


'/>"/>
Contact: Katie Delach
katie.delach@uphs.upenn.edu
215-349-5964
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Patients requesting prophylactic mastectomies overestimate their breast cancer risk
2. Study finds side effects, complications, mastectomy more likely after partial breast irradiation
3. Rates of breast reconstruction after mastectomy in Canada
4. Georgetown researchers examine 21-year series of nipple sparing mastectomy cases and find no cancers
5. Advanced post-mastectomy breast reconstruction improves womens psychosocial and sexual well-being
6. Young women with early breast cancer have similar survival with breast conservation, mastectomy
7. Reconstruction Safe Right After Mastectomy: Study
8. Improvement needed for mastectomy outcome reporting
9. Annual Mammograms May Cut Mastectomy Rate for Some
10. Annual breast cancer screening beginning at age 40 reduces mastectomy risk
11. Silicone Implants Preferred by Mastectomy Patients: Survey
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/21/2017)... (PRWEB) , ... July 21, 2017 , ... ... management assistance and financial planning services to families and business owners in northern ... event that promises to provide support to area adults with developmental challenges. , ...
(Date:7/21/2017)... ... July 21, 2017 , ... ... selected to renovate and improve the Ramsey County Medical Examiners Facility located in ... Hospital, the $2.5 million project is scheduled to start in late 2017/early 2018. ...
(Date:7/21/2017)... , ... July 21, 2017 , ... ... and Theater of Witness , was awarded a $300,000 grant from ... program which fosters empathy, comfort with ambiguity and the recognition of one’s own ...
(Date:7/21/2017)... ... 2017 , ... Bernard R. Bach, Jr., MD, orthopaedic surgeon at Rush University ... of Sports Medicine (AOSSM) , received the 2017 Robert E. Leach Sports Medicine Leadership ... This prestigious award is given annually to honor those who have made a significant ...
(Date:7/21/2017)... ... July 21, 2017 , ... Yisrayl Hawkins, Pastor and Overseer at The House of ... of violence and aggression to solve problems and pleads with world leaders to be more ... forces do not bring peace. He says there is a peaceful and positive way to ...
Breaking Medicine News(10 mins):
(Date:7/10/2017)... 2017  BDI Group subsidiary Pathway Purchasing Network, ... organization serving specialty pharmacies, home infusion companies and ... significant, value-added member programs designed to help organizations ... and improve access and affordability for patients who ... Pathway has worked ...
(Date:7/10/2017)... , July 10, 2017 Locus Biosciences ... Note to support the development of CRISPR-Cas3 antimicrobial therapeutics. ... Limited, a leading Chinese Internet services provider, and joined ... advance multiple infectious disease product programs targeting antibiotic resistant ... Founded by Dr. Rodolphe Barrangou ...
(Date:7/5/2017)... , July 5, 2017 Wolfmet 3D ... answer as physics and manufacturing combine to progress molecular radiotherapy ... existing SPECT systems are unable to accurately quantify the radiation ... limited information regarding the success of this radiotherapy treatment has ... ...
Breaking Medicine Technology: