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Expert Discusses Recommending Against Prophylactic Mastectomy

Angelica Welch
Published: Friday, Apr 14, 2017

Steven J. Katz, MD

Steven J. Katz, MD

Desire to undergo a contralateral prophylactic mastectomy (CPM) has been rising in patients diagnosed with breast cancer in recent years. CPM is discouraged for patients without an elevated risk for a second primary breast cancer, as per surgical guidelines.

, Katz, professor of medicine and health management and policy at the University of Michigan, discussed his study of patient reaction to surgeon recommendations about CPM.

OncLive: Could you provide some background on the rationale behind this study?

Katz: CPM for women with early-stage breast cancer is a major issue that has evolved over the past 5 to 7 years and the number of the women undergoing this most extensive surgical treatment has increased rather dramatically. This is probably related to more attention given to the procedure from famous people who got it, and with more women getting CPM in the community—newly diagnosed patients know of a daughter or mother or friend who have had it and are very happy with the fact that they feel that they are completely free of any future possibility of having the caner. The problem with this mindset is that many women getting CPM are at average risk for a second primary cancer. The risk of developing a secondary breast cancer is so low, given all of the other reasons, that CPM in average-risk women does not confer any benefit with regard to survival or even distant recurrence. Additionally, reconstructive surgery means more days lost at work and long-term quality-of-life issues related to not having the natural breast.
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