1932

Abstract

Breast-conserving therapy (BCT) and mastectomy result in equivalent long-term survival. Locoregional recurrence rates after BCT have decreased over time and are now similar to those after mastectomy. Contralateral breast cancer rates are declining as well owing to the widespread use of adjuvant systemic therapy. Despite these improved outcomes, increasing rates of bilateral mastectomy for unilateral cancer have been observed in the United States. Medical indications for mastectomy are well defined and present in a minority of patients, and women at increased risk for contralateral cancer are a small proportion of the breast cancer population. Evidence indicates that increasing use of mastectomy is a patient-driven trend that is most pronounced among younger, educated, and well-insured women, and reflects fear of recurrence and in some cases misunderstanding of future cancer risks. Although satisfaction levels are generally high among patients choosing contralateral prophylactic mastectomy, complications and procedure extent may be underestimated. Improved communication strategies are essential to facilitate this complex decision-making process.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-043015-075227
2017-01-14
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/med/68/1/annurev-med-043015-075227.html?itemId=/content/journals/10.1146/annurev-med-043015-075227&mimeType=html&fmt=ahah

Literature Cited

  1. Darby S, McGale P, Correa C. 1.  et al. 2011. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378:1707–16 [Google Scholar]
  2. Anderson SJ, Wapnir I, Dignam JJ. 2.  et al. 2009. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J. Clin. Oncol. 27:2466–73 [Google Scholar]
  3. Zumsteg ZS, Morrow M, Arnold B. 3.  et al. 2013. Breast-conserving therapy achieves locoregional outcomes comparable to mastectomy in women with T1-2N0 triple-negative breast cancer. Ann. Surg. Oncol. 20:3469–76 [Google Scholar]
  4. Albornoz CR, Matros E, Lee CN. 4.  et al. 2015. Bilateral mastectomy versus breast-conserving surgery for early-stage breast cancer: the role of breast reconstruction. Plast. Reconstr. Surg. 135:1518–26 [Google Scholar]
  5. Garcia-Etienne CA, Tomatis M, Heil J. 5.  et al. 2012. Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database. Eur. J. Cancer 48:1947–56 [Google Scholar]
  6. Cemal Y, Albornoz CR, Disa JJ. 6.  et al. 2013. A paradigm shift in U.S. breast reconstruction: Part 2. The influence of changing mastectomy patterns on reconstructive rate and method. Plast. Reconstr. Surg. 131:320e–26e [Google Scholar]
  7. Wapnir IL, Anderson SJ, Mamounas EP. 7.  et al. 2006. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National Surgical Adjuvant Breast and Bowel Project node-positive adjuvant breast cancer trials. J. Clin. Oncol. 24:2028–37 [Google Scholar]
  8. Svahn TH, Niland JC, Carlson RW. 8.  et al. 2009. Predictors and temporal trends of adjuvant aromatase inhibitor use in breast cancer. J. Natl. Compr. Cancer Netw. 7:115–21 [Google Scholar]
  9. 9. Early Breast Cancer Trialists' Collaborative Group. 1995. Effects of radiotherapy and surgery in early breast cancer. An overview of the randomized trials. N. Engl. J. Med. 333:1444–55 [Google Scholar]
  10. Fisher B, Anderson S, Bryant J. 10.  et al. 2002. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N. Engl. J. Med. 347:1233–41 [Google Scholar]
  11. Veronesi U, Cascinelli N, Mariani L. 11.  et al. 2002. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N. Engl. J. Med. 347:1227–32 [Google Scholar]
  12. van Dongen JA, Voogd AC, Fentiman IS. 12.  et al. 2000. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J. Natl. Cancer Inst. 92:1143–50 [Google Scholar]
  13. Lowery AJ, Kell MR, Glynn RW. 13.  et al. 2012. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res. Treat. 133:831–41 [Google Scholar]
  14. Abdulkarim BS, Cuartero J, Hanson J. 14.  et al. 2011. Increased risk of locoregional recurrence for women with T1-2N0 triple-negative breast cancer treated with modified radical mastectomy without adjuvant radiation therapy compared with breast-conserving therapy. J. Clin. Oncol. 29:2852–58 [Google Scholar]
  15. Adkins FC, Gonzalez-Angulo AM, Lei X. 15.  et al. 2011. Triple-negative breast cancer is not a contraindication for breast conservation. Ann. Surg. Oncol. 18:3164–73 [Google Scholar]
  16. Davies C, Godwin J, Gray R. 16.  et al. 2011. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378:771–84 [Google Scholar]
  17. Dowsett M, Cuzick J, Ingle J. 17.  et al. 2010. Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J. Clin. Oncol. 28:509–18 [Google Scholar]
  18. Fisher B, Dignam J, Mamounas EP. 18.  et al. 1996. Sequential methotrexate and fluorouracil for the treatment of node-negative breast cancer patients with estrogen receptor-negative tumors: eight-year results from National Surgical Adjuvant Breast and Bowel Project (NSABP) B-13 and first report of findings from NSABP B-19 comparing methotrexate and fluorouracil with conventional cyclophosphamide, methotrexate, and fluorouracil. J. Clin. Oncol. 14:1982–92 [Google Scholar]
  19. Gianni L, Dafni U, Gelber RD. 19.  et al. 2011. Treatment with trastuzumab for 1 year after adjuvant chemotherapy in patients with HER2-positive early breast cancer: a 4-year follow-up of a randomised controlled trial. Lancet Oncol 12:236–44 [Google Scholar]
  20. Goss PE, Ingle JN, Martino S. 20.  et al. 2005. Randomized trial of letrozole following tamoxifen as extended adjuvant therapy in receptor-positive breast cancer: updated findings from NCIC CTG MA.17. J. Natl. Cancer Inst. 97:1262–71 [Google Scholar]
  21. Mamounas EP, Tang G, Fisher B. 21.  et al. 2010. Association between the 21-gene recurrence score assay and risk of locoregional recurrence in node-negative, estrogen receptor-positive breast cancer: results from NSABP B-14 and NSABP B-20. J. Clin. Oncol. 28:1677–83 [Google Scholar]
  22. Perez EA, Romond EH, Suman VJ. 22.  et al. 2014. Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831. J. Clin. Oncol. 32:3744–52 [Google Scholar]
  23. 23. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). 2005. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–717 [Google Scholar]
  24. Kiess AP, McArthur HL, Mahoney K. 24.  et al. 2012. Adjuvant trastuzumab reduces locoregional recurrence in women who receive breast-conservation therapy for lymph node-negative, human epidermal growth factor receptor 2-positive breast cancer. Cancer 118:1982–88 [Google Scholar]
  25. Slamon D, Eiermann W, Robert N. 25.  et al. 2011. Adjuvant trastuzumab in HER2-positive breast cancer. N. Engl. J. Med. 365:1273–83 [Google Scholar]
  26. 26.  Kim MM, Dawood S, Allen P et al. 2012. Hormone receptor status influences the locoregional benefit of trastuzumab in patients with nonmetastatic breast cancer. Cancer 118:4936–43 [Google Scholar]
  27. Bouganim N, Tsvetkova E, Clemons M, Amir E. 27.  2013. Evolution of sites of recurrence after early breast cancer over the last 20 years: implications for patient care and future research. Breast Cancer Res. Treat. 139:603–6 [Google Scholar]
  28. Schell SR, Montague ED, Spanos WJ Jr.. 28.  et al. 1982. Bilateral breast cancer in patients with initial stage I and II disease. Cancer 50:1191–94 [Google Scholar]
  29. Chaudary MA, Millis RR, Hoskins EO. 29.  et al. 1984. Bilateral primary breast cancer: a prospective study of disease incidence. Br. J. Surg. 71:711–14 [Google Scholar]
  30. Schellong G, Riepenhausen M, Ehlert K. 30.  et al. 2014. Breast cancer in young women after treatment for Hodgkin's disease during childhood or adolescence—an observational study with up to 33-year follow-up. Dtsch. Arztebl. Int. 111:3–9 [Google Scholar]
  31. Moskowitz CS, Chou JF, Wolden SL. 31.  et al. 2014. Breast cancer after chest radiation therapy for childhood cancer. J. Clin. Oncol. 32:2217–23 [Google Scholar]
  32. Morrow M, Strom EA, Bassett LW. 32.  et al. 2002. Standard for breast conservation therapy in the management of invasive breast carcinoma. CA Cancer J. Clin. 52:277–300 [Google Scholar]
  33. Wilson LD, Beinfield M, McKhann CF. 33.  et al. 1993. Conservative surgery and radiation in the treatment of synchronous ipsilateral breast cancers. Cancer 72:137–42 [Google Scholar]
  34. Kurtz JM, Jacquemier J, Amalric R. 34.  et al. 1990. Breast-conserving therapy for macroscopically multiple cancers. Ann. Surg. 212:38–44 [Google Scholar]
  35. Leopold KA, Recht A, Schnitt SJ. 35.  et al. 1989. Results of conservative surgery and radiation therapy for multiple synchronous cancers of one breast. Int. J. Radiat. Oncol. Biol. Phys. 16:11–16 [Google Scholar]
  36. Coopey S, Smith BL, Hanson S. 36.  et al. 2011. The safety of multiple re-excisions after lumpectomy for breast cancer. Ann. Surg. Oncol. 18:3797–801 [Google Scholar]
  37. Chen AM, Obedian E, Haffty BG. 37.  2001. Breast-conserving therapy in the setting of collagen vascular disease. Cancer J 7:480–91 [Google Scholar]
  38. McCormick B. 38.  1994. Selection criteria for breast conservation. The impact of young and old age and collagen vascular disease. Cancer 74:430–35 [Google Scholar]
  39. Fleck R, McNeese MD, Ellerbroek NA. 39.  et al. 1989. Consequences of breast irradiation in patients with pre-existing collagen vascular diseases. Int. J. Radiat. Oncol. Biol. Phys. 17:829–33 [Google Scholar]
  40. Wo J, Taghian A. 40.  2007. Radiotherapy in setting of collagen vascular disease. Int. J. Radiat. Oncol. Biol. Phys. 69:1347–53 [Google Scholar]
  41. Mahmood U, Hanlon AL, Koshy M. 41.  et al. 2013. Increasing national mastectomy rates for the treatment of early stage breast cancer. Ann. Surg. Oncol. 20:1436–43 [Google Scholar]
  42. King TA, Morrow M. 42.  2015. Surgical issues in patients with breast cancer receiving neoadjuvant chemotherapy. Nat. Rev. Clin. Oncol. 12:335–43 [Google Scholar]
  43. Morrow M, Jagsi R, Alderman AK. 43.  et al. 2009. Surgeon recommendations and receipt of mastectomy for treatment of breast cancer. JAMA 302:1551–56 [Google Scholar]
  44. Gao X, Fisher SG, Emami B. 44.  2003. Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: a population-based study. Int. J. Radiat. Oncol. Biol. Phys. 56:1038–45 [Google Scholar]
  45. Abbott A, Rueth N, Pappas-Varco S. 45.  et al. 2011. Perceptions of contralateral breast cancer: an overestimation of risk. Ann. Surg. Oncol. 18:3129–36 [Google Scholar]
  46. Hislop TG, Elwood JM, Coldman AJ. 46.  et al. 1984. Second primary cancers of the breast: incidence and risk factors. Br. J. Cancer 49:79–85 [Google Scholar]
  47. Saphner T, Tormey DC, Gray R. 47.  1996. Annual hazard rates of recurrence for breast cancer after primary therapy. J. Clin. Oncol. 14:2738–46 [Google Scholar]
  48. Rosen PP, Groshen S, Kinne DW, Hellman S. 48.  1989. Contralateral breast carcinoma: an assessment of risk and prognosis in stage I (T1N0M0) and stage II (T1N1M0) patients with 20-year follow-up. Surgery 106:904–10 [Google Scholar]
  49. Nichols HB, Berrington de González A, Lacey JV Jr.. 49.  et al. 2011. Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J. Clin. Oncol. 29:1564–69 [Google Scholar]
  50. Bedrosian I, Hu CY, Chang GJ. 50.  2010. Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients. J. Natl. Cancer Inst. 102:401–9 [Google Scholar]
  51. Neta G, Anderson WF, Gilbert E. 51.  et al. 2012. Variation in the risk of radiation-related contralateral breast cancer by histology and estrogen receptor expression in SEER. Breast Cancer Res. Treat. 131:1021–27 [Google Scholar]
  52. Pesce C, Liederbach E, Wang C. 52.  et al. 2014. Contralateral prophylactic mastectomy provides no survival benefit in young women with estrogen receptor-negative breast cancer. Ann. Surg. Oncol. 21:3231–39 [Google Scholar]
  53. Kurian AW, Lichtensztajn DY, Keegan TH. 53.  et al. 2014. Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998–2011. JAMA 312:902–14 [Google Scholar]
  54. Yao K, Winchester DJ, Czechura T. 54.  et al. 2013. Contralateral prophylactic mastectomy and survival: report from the National Cancer Data Base, 1998–2002. Breast Cancer Res. Treat. 142:465–76 [Google Scholar]
  55. Wong SM, Freedman RA, Sagara Y. >54.  et al. 2016. Growing use of contralateral prophylactic mastectomy despite no improvement in long-term survival for invasive breast cancer. Ann. Surg. In press
  56. Chen S, Parmigiani G. 56.  2007. Meta-analysis of BRCA1 and BRCA2 penetrance. J. Clin. Oncol. 25:1329–33 [Google Scholar]
  57. Antoniou A, Pharoah PD, Narod S. 57.  et al. 2003. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am. J. Hum. Genet. 72:1117–30 [Google Scholar]
  58. Malone KE, Begg CB, Haile RW. 58.  et al. 2010. Population-based study of the risk of second primary contralateral breast cancer associated with carrying a mutation in BRCA1 or BRCA2. J. Clin. Oncol. 28:2404–10 [Google Scholar]
  59. Graeser MK, Engel C, Rhiem K. 59.  et al. 2009. Contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers. J. Clin. Oncol. 27:5887–92 [Google Scholar]
  60. Metcalfe K, Lynch HT, Ghadirian P. 60.  et al. 2011. Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res. Treat. 127:287–96 [Google Scholar]
  61. Pierce LJ, Levin AM, Rebbeck TR. 61.  et al. 2006. Ten-year multi-institutional results of breast-conserving surgery and radiotherapy in BRCA1/2-associated stage I/II breast cancer. J. Clin. Oncol. 24:2437–43 [Google Scholar]
  62. LaDuca H, Stuenkel AJ, Dolinsky JS. 62.  et al. 2014. Utilization of multigene panels in hereditary cancer predisposition testing: analysis of more than 2,000 patients. Genet. Med. 16:830–37 [Google Scholar]
  63. Tung N, Battelli C, Allen B. 63.  et al. 2015. Frequency of mutations in individuals with breast cancer referred for BRCA1 and BRCA2 testing using next-generation sequencing with a 25-gene panel. Cancer 121:25–33 [Google Scholar]
  64. Hawley ST, Jagsi R, Morrow M. 64.  et al. 2014. Social and clinical determinants of contralateral prophylactic mastectomy. JAMA Surg 149:582–89 [Google Scholar]
  65. Katz SJ, Lantz PM, Janz NK. 65.  et al. 2005. Patient involvement in surgery treatment decisions for breast cancer. J. Clin. Oncol. 23:5526–33 [Google Scholar]
  66. Hawley ST, Griggs JJ, Hamilton AS. 66.  et al. 2009. Decision involvement and receipt of mastectomy among racially and ethnically diverse breast cancer patients. J. Natl. Cancer Inst. 101:1337–47 [Google Scholar]
  67. McLaughlin SA, Stempel M, Morris EA. 67.  et al. 2008. Can magnetic resonance imaging be used to select patients for sentinel lymph node biopsy in prophylactic mastectomy?. Cancer 112:1214–21 [Google Scholar]
  68. Tuttle TM, Jarosek S, Habermann EB. 68.  et al. 2009. Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. J. Clin. Oncol. 27:1362–67 [Google Scholar]
  69. Arrington AK, Jarosek SL, Virnig BA. 69.  et al. 2009. Patient and surgeon characteristics associated with increased use of contralateral prophylactic mastectomy in patients with breast cancer. Ann. Surg. Oncol. 16:2697–704 [Google Scholar]
  70. Yao K, Stewart AK, Winchester DJ. 70.  et al. 2010. Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998–2007. Ann. Surg. Oncol. 17:2554–62 [Google Scholar]
  71. Jones NB, Wilson J, Kotur L. 71.  et al. 2009. Contralateral prophylactic mastectomy for unilateral breast cancer: an increasing trend at a single institution. Ann. Surg. Oncol. 16:2691–96 [Google Scholar]
  72. King TA, Sakr R, Patil S. 72.  et al. 2011. Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J. Clin. Oncol. 29:2158–64 [Google Scholar]
  73. Jagsi R, Hawley ST, Griffith KA. 73.  et al. 2015. Contralateral prophylactic mastectomy decision-making in the population-based iCanCare study of early-stage breast cancer patients: knowledge and physician influence Presented at Am. Soc. Clin. Oncol. Annu. Meet. Chicago, IL: May 29–June 2
  74. Rosenberg SM, Tracy MS, Meyer ME. 74.  et al. 2013. Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: a cross-sectional survey. Ann. Intern. Med. 159:373–81 [Google Scholar]
  75. Katz SJ, Morrow M. 75.  2012. The challenge of individualizing treatments for patients with breast cancer. JAMA 307:1379–80 [Google Scholar]
  76. Koslow S, Pharmer LA, Scott AM. 76.  et al. 2013. Long-term patient-reported satisfaction after contralateral prophylactic mastectomy and implant reconstruction. Ann. Surg. Oncol. 20:3422–29 [Google Scholar]
  77. Frost MH, Hoskin TL, Hartmann LC. 77.  et al. 2011. Contralateral prophylactic mastectomy: long-term consistency of satisfaction and adverse effects and the significance of informed decision-making, quality of life, and personality traits. Ann. Surg. Oncol. 18:3110–16 [Google Scholar]
  78. Boughey JC, Hoskin TL, Hartmann LC. 78.  et al. 2015. Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy. Ann. Surg. Oncol. 22:401–8 [Google Scholar]
  79. Craft RO, Colakoglu S, Curtis MS. 79.  et al. 2011. Patient satisfaction in unilateral and bilateral breast reconstruction. Plast. Reconstr. Surg. 127:1417–24 [Google Scholar]
  80. Silva AK, Lapin B, Yao KA. 80.  et al. 2015. The effect of contralateral prophylactic mastectomy on perioperative complications in women undergoing immediate breast reconstruction: a NSQIP analysis. Ann. Surg. Oncol. 22:3474–80 [Google Scholar]
/content/journals/10.1146/annurev-med-043015-075227
Loading
/content/journals/10.1146/annurev-med-043015-075227
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error