Researchers identify risk factors for contralateral bre...( HOUSTON - A preventive procedure to ...),Health

HOUSTON - A preventive procedure to remove the unaffected breast in breast cancer patients with disease in one breast may only be necessary in patients who have high-risk features as assessed by examining the patient's medical history and pathology of the breast cancer, according to researchers at The University of Texas M. D. Anderson Cancer Center.

Their findings, published in the March 1, 2009 issue of Cancer, may help physicians predict the likelihood of patients developing breast cancer in the opposite breast (contralateral breast cancer), stratify risk and counsel patients on their treatment options.

"Women often consider contralateral prophylactic mastectomy (CPM) not because of medical recommendation, but because they fear having their breast cancer return," said Kelly Hunt, M.D., professor in the Department of Surgical Oncology at M. D. Anderson and lead author on the study. "Currently it is very difficult to identify which patients are at enough risk to benefit from this aggressive and irreversible procedure. Our goal was to determine what characteristics defined these high-risk patients to better inform future decisions regarding CPM."

According to the researchers, approximately 2.7 percent of women diagnosed with breast cancer choose to have CPM. Recent statistics have shown that the rate of CPM in women with stage I-III breast cancer increased by 150 percent from 1998 to 2003 in the United States. Potential reasons breast cancer patients choose to undergo CPM include risk reduction, difficult surveillance and reconstructive issues such as symmetry and/or balance.

To begin to classify such risk factors, researchers reviewed the cases of 542 women with breast cancer only in one breast who received CPM to remove the second breast at M. D. Anderson from January 2000 to April 2007. Out of this group, 435 patients had no abnormal pathology identified in the opposite breast, 25 patients had contralateral breast
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