Contralateral Prophylactic Mastectomy: Perceptions Versus Reality
Authors: Pamela R. Portschy, Todd M. Tuttle
Journal: Annals of Internal Medicine (2013)

EditorialsSeptember 17, 2013Contralateral Prophylactic Mastectomy: Perceptions Versus RealityPamela R. Portschy, MD and Todd M. Tuttle, MD, MSPamela R. Portschy, MDFrom University of Minnesota, Minneapolis, Minnesota.Search for more papers by this author and Todd M. Tuttle, MD, MSFrom University of Minnesota, Minneapolis, Minnesota.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-6-201309170-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail There are things known and there are things unknown, and in between are the doors of perception.—Aldous HuxleyThe important and timely study by Rosenberg and colleagues in this issue (1) evaluated preferences, knowledge, decision making, and experiences of young women with breast cancer who chose contralateral prophylactic mastectomy (CPM). The authors concluded that young women who have the procedure markedly overestimate their risk for contralateral breast cancer (CBC). Other studies have reported that a substantial proportion of women overestimate their risk for breast cancer events. For example, in a study of 200 women without breast cancer, Black and coworkers ...References1. Rosenberg SM, Tracy MS, Meyer ME, Sepucha K, Gelber S, Hirshfield-Bartek J, et al. Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer. A cross-sectional survey. Ann Intern Med. 2013;159:373-81. LinkGoogle Scholar2. Black WC, Nease RF, and Tosteson AN. Perceptions of breast cancer risk and screening effectiveness in women younger than 50 years of age. J Natl Cancer Inst. 1995;87:720-31. [PMID: 7563149] CrossrefMedlineGoogle Scholar3. Rakovitch E, Franssen E, Kim J, Ackerman I, Pignol JP, Paszat L, et al. A comparison of risk perception and psychological morbidity in women with ductal carcinoma in situ and early invasive breast cancer. Breast Cancer Res Treat. 2003;77:285-93. [PMID: 12602928] CrossrefMedlineGoogle Scholar4. Abbott A, Rueth N, Pappas-Varco S, Kuntz K, Kerr E, and Tuttle T. Perceptions of contralateral breast cancer: an overestimation of risk. Ann Surg Oncol. 2011;18:3129-36. [PMID: 21947590] CrossrefMedlineGoogle Scholar5. Altschuler A, Nekhlyudov L, Rolnick SJ, Greene SM, Elmore JG, West CN, et al. Positive, negative, and disparate—women's differing long-term psychosocial experiences of bilateral or contralateral prophylactic mastectomy. Breast J. 2008;14:25-32. [PMID: 18186862] CrossrefMedlineGoogle Scholar6. Tuttle TM, Habermann EB, Grund EH, Morris TJ, and Virnig BA. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25:5203-9. [PMID: 17954711] CrossrefMedlineGoogle Scholar7. Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, et al. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011;378:771-84. [PMID: 21802721] CrossrefMedlineGoogle Scholar8. Nichols HB, Berrington de González A, Lacey JV, Rosenberg PS, and Anderson WF. Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol. 2011;29:1564-9. [PMID: 21402610] CrossrefMedlineGoogle Scholar9. Quan G, Pommier SJ, and Pommier RF. Incidence and outcomes of contralateral breast cancers. Am J Surg. 2008;195:645-50. [PMID: 18424281] CrossrefMedlineGoogle Scholar10. Goldflam K, Hunt KK, Gershenwald JE, Singletary SE, Mirza N, Kuerer HM, et al. Contralateral prophylactic mastectomy. Predictors of significant histologic findings. Cancer. 2004;101:1977-86. [PMID: 15389473] CrossrefMedlineGoogle Scholar11. Frost MH, Slezak JM, Tran NV, Williams CI, Johnson JL, Woods JE, et al. Satisfaction after contralateral prophylactic mastectomy: the significance of mastectomy type, reconstructive complications, and body appearance. J Clin Oncol. 2005;23:7849-56. [PMID: 16204003] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Minnesota, Minneapolis, Minnesota.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1840.Corresponding Author: Todd M. Tuttle, MD, MS, Department of Surgery, University of Minnesota, 420 Delaware Street, Mayo Mail Code 195, Minneapolis, MN 55455; e-mail, [email protected].Current Author Addresses: Drs. Portschy and Tuttle: Department of Surgery, University of Minnesota, 420 Delaware Street, Mayo Mail Code 195, Minneapolis, MN 55455. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPerceptions, Knowledge, and Satisfaction With Contralateral Prophylactic Mastectomy Among Young Women With Breast Cancer Shoshana M. Rosenberg , Michaela S. Tracy , Meghan E. Meyer , Karen Sepucha , Shari Gelber , Judi Hirshfield-Bartek , Susan Troyan , Monica Morrow , Lidia Schapira , Steven E. Come , Eric P. Winer , and Ann H. Partridge Metrics September 17, 2013Volume 159, Issue 6Page: 428-429KeywordsBilateral mastectomyBreast cancerDeath ratesDecision makingDuctal carcinoma in situEstrogensInpatientsMotivationPerceptionProspective studiesSurgery ePublished: 17 September 2013 Issue Published: September 17, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...