Journal article
Rate of Contralateral Prophylactic Mastectomy is Influenced by Preoperative MRI Recommendations
Annals of surgical oncology, Vol.21(13), pp.4133-4138
12/2014
DOI: 10.1245/s10434-014-3852-x
PMCID: PMC4255269
PMID: 24934585
Abstract
Women with breast cancer increasingly undergo contralateral prophylactic mastectomy (CPM). We evaluated the relationship between preoperative magnetic resonance imaging (MRI) findings and CPM. Other clinicopathologic variables associated with CPM choice and the pathology found in the contralateral breast are also reported.Newly diagnosed breast cancer patients were prospectively enrolled in the University of Iowa Breast Molecular Epidemiology Resource. Patients with stages 0–III breast cancer who underwent mastectomy for the index cancer were eligible for this analysis. Univariate logistic regression and a multivariate model were used to identify factors predictive of CPM.Among 134 patients (mean age 54.9 years), 53 (39.6 %) chose CPM. On univariate analysis, patients undergoing CPM were more likely to have a preoperative breast MRI (64.2 vs. 39.5 %, p = 0.006) and to have follow-up testing recommended for the contralateral breast (28.3 vs. 4.9 %, p = 0.001). Univariate analysis also associated CPM with younger age (p < 0.0001), BRCA testing (p < 0.0001), BRCA mutation (p = 0.034) and reconstruction performed (p = 0.001). Median age of youngest child at diagnosis varied significantly between the CPM (15.9 years) and non-CPM (24.3 years) groups (p = 0.0018). On multivariate analysis, MRI follow-up recommendation, young age, reconstruction and human epidermal growth factor receptor 2 (HER2) positivity of the index cancer were significantly associated with CPM. Of the CPM specimens, one (1.8 %) had ductal carcinoma-in situ, which had not been identified on MRI.Abnormal findings in the contralateral breast on preoperative MRI, as well as young age, reconstruction and HER2-positive status correlated with CPM choice in this cohort. Occult malignancy was rare.
Details
- Title: Subtitle
- Rate of Contralateral Prophylactic Mastectomy is Influenced by Preoperative MRI Recommendations
- Creators
- Chang Xia - Division of Hematology, Oncology and Blood and Marrow Transplantation, Department of Internal Medicine University of Iowa Iowa City IA USAMary Schroeder - Department of Pharmacy Practice and Science, College of Pharmacy University of Iowa Iowa City IA USARonald Weigel - Department of Surgery University of Iowa Iowa City IA USASonia Sugg - Department of Surgery University of Iowa Iowa City IA USAAlexandra Thomas - Division of Hematology, Oncology and Blood and Marrow Transplantation, Department of Internal Medicine University of Iowa Iowa City IA USA
- Resource Type
- Journal article
- Publication Details
- Annals of surgical oncology, Vol.21(13), pp.4133-4138
- DOI
- 10.1245/s10434-014-3852-x
- PMID
- 24934585
- PMCID
- PMC4255269
- NLM abbreviation
- Ann Surg Oncol
- ISSN
- 1068-9265
- eISSN
- 1534-4681
- Publisher
- Springer US; Boston
- Language
- English
- Date published
- 12/2014
- Academic Unit
- Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Pharmacy Practice and Science; Biochemistry and Molecular Biology; Internal Medicine
- Record Identifier
- 9984024401602771
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