Abstract
The American Society of Breast Surgeons (ASBrS) encourages an evidence-based and patient value focused approach to contralateral prophylactic mastectomy (CPM). The ASBrS convened a panel of experts to develop a consensus statement on CPM.1 The majority of women will obtain no oncologic benefit from CPM, and therefore CPM should be discouraged in average-risk women with unilateral breast cancer. Consideration of the patient’s preferences and values and an informed discussion of the risks and benefits of CPM is recommended for all patients pursuing mastectomy, along with a direct recommendation by the surgeon for or against CPM.
Highlights
Summary CPM is a cost-effective strategy for women with BRCA mutations
An initial Markov model study found that CPM was cost effective compared with surveillance for patients younger than 70 years, but this finding was highly dependent on the quality of life assumptions.[17]
The available data on cost effectiveness for CPM is limited to modeling studies and does not provide strong scientific evidence to support CPM as a cost effective strategy
Summary
The benefit of performing sentinel lymph node (SLN) surgery at the time of CPM is that the lymph nodes have been. This article is published with open access at Springerlink.com. Patients at higher risk of contralateral occult malignancy are postmenopausal patients, those with triple-negative, locally advanced, inflammatory, or invasive lobular disease.[3,8,9,10] MRI at the time of breast cancer diagnosis identifies occult contralateral disease 2–4 % of the time.[11] Suspicious lesions in the contralateral breast should be biopsied, but if a biopsy is not done, SLN surgery should be considered for highly suspicious lesions. Summary Sentinel lymph node surgery on the CPM side should not be routinely performed
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