, Volume 21, Issue 11, pp 3372-3374
Date: 22 Jul 2014

Contralateral Prophylactic Mastectomy and Survival: An Ongoing Challenge

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As use of contralateral prophylactic mastectomy (CPM) continues to increase, the need to demonstrate oncologic benefit to patients undergoing this procedure becomes ever more important. Whereas CPM has consistently been shown to reduce the incidence of second, contralateral breast cancer events, demonstrating survival benefit from CPM has been more challenging. In this edition of the Annals of Surgical Oncology, Kruper et al. report on their attempt to answer this question by using data from SEER, the Surveillance, Epidemiology, and End Results database. They evaluated the outcome of 26,526 women who underwent CPM and 138,826 patients who underwent single mastectomy. After propensity score matched analysis, they found CPM was associated with improved disease-specific survival [hazard ratio (HR) 0.86, 95 % confidence interval (CI) 0.79–0.93] but a much greater improvement in overall survival (HR 0.76, 95 % CI 0.71–0.81); this pattern was seen in almost all subsets of patients examined. ...