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Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Rates of contralateral mastectomy (CM) among patients with unilateral breast cancer have been increasing in the United States. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, risks, and benefits of CM since the society’s 2017 statement. We held a virtual meeting to outline key topics and then conducted a literature search using PubMed to identify relevant articles. We reviewed the articles and made recommendations based on group consensus. Patients consider CM for many reasons, including concerns regarding the risk of contralateral breast cancer (CBC), desire for improved cosmesis and symmetry, and preferences to avoid ongoing screening, whereas surgeons primarily consider CBC risk when making a recommendation for CM. For patients with a high risk of CBC, CM reduces the risk of new breast cancer, however it is not known to convey an overall survival benefit. Studies evaluating patient satisfaction with CM and reconstruction have yielded mixed results. Imaging with mammography within 12 months before CM is recommended, but routine preoperative breast magnetic resonance imaging is not; there is also no evidence to support routine postmastectomy imaging surveillance. Because the likelihood of identifying an occult malignancy during CM is low, routine sentinel lymph node surgery is not recommended. Data on the rates of postoperative complications are conflicting, and such complications may not be directly related to CM. Adjuvant therapy delays due to complications have not been reported. Surgeons can reduce CM rates by encouraging shared decision making and informed discussions incorporating patient preferences.

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References

  1. Nelson JA, Rubenstein RN, Haglich K, et al. Analysis of a trend reversal in US lumpectomy rates from 2005 through 2017 using 3 nationwide data sets. JAMA Surg. 2022;157(8):702–11.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Arthur DW, Winter KA, Kuerer HM, et al. Effectiveness of breast-conserving surgery and 3-dimensional conformal partial breast reirradiation for recurrence of breast cancer in the ipsilateral breast: the NRG Oncology/RTOG 1014 Phase 2 Clinical Trial. JAMA Oncol. 2020;6(1):75–82.

    Article  PubMed  Google Scholar 

  3. Boughey JC, Rosenkranz KM, Ballman KV, et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023;41(17):3184–93.

    Article  CAS  PubMed  Google Scholar 

  4. De la Cruz KuG, Karamchandani M, Chambergo-Michilot D, et al. Does breast-conserving surgery with radiotherapy have a better survival than mastectomy? A meta-analysis of more than 1,500,000 patients. Ann Surg Oncol. 2022;29(10):6163–88.

    Article  Google Scholar 

  5. van Maaren MC, de Munck L, de Bock GH, et al. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands: a population-based study. Lancet Oncol. 2016;17(8):1158–70.

    Article  PubMed  Google Scholar 

  6. Hunt KK, Euhus DM, Boughey JC, et al. Society of surgical oncology breast disease working group statement on prophylactic (risk-reducing) mastectomy. Ann Surg Oncol. 2017;24(2):375–97.

    Article  PubMed  Google Scholar 

  7. Tuttle TM, Habermann EB, Grund EH, Morris TJ, Virnig BA. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25(33):5203–9.

    Article  PubMed  Google Scholar 

  8. Yao K, Stewart AK, Winchester DJ, Winchester DP. Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998–2007. Ann Surg Oncol. 2010;17(10):2554–62.

    Article  PubMed  Google Scholar 

  9. Mamtani A, Sjoberg DD, Vincent A, et al. Does a brief surgeon training in negotiation theory principles decrease rates of contralateral prophylactic mastectomy? Breast Cancer Res Treat. 2023;199(1):119–26.

    Article  CAS  PubMed  Google Scholar 

  10. King TA, Sakr R, Patil S, et al. Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol. 2011;29(16):2158–64.

    Article  PubMed  Google Scholar 

  11. Nash R, Goodman M, Lin CC, et al. State variation in the receipt of a contralateral prophylactic mastectomy among women who received a diagnosis of invasive unilateral early-stage breast cancer in the United States, 2004–2012. JAMA Surg. 2017;152(7):648–57.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lim DW, Metcalfe KA, Narod SA. Bilateral mastectomy in women with unilateral breast cancer: a review. JAMA Surg. 2021;156(6):569–76.

    Article  PubMed  Google Scholar 

  13. Tuttle TM, Jarosek S, Habermann EB, et al. Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. J Clin Oncol. 2009;27(9):1362–7.

    Article  PubMed  Google Scholar 

  14. Yi M, Hunt KK, Arun BK, et al. Factors affecting the decision of breast cancer patients to undergo contralateral prophylactic mastectomy. Cancer Prev Res. 2010;3(8):1026–34.

    Article  Google Scholar 

  15. Katz SJ, Hawley ST, Hamilton AS, et al. Surgeon influence on variation in receipt of contralateral prophylactic mastectomy for women with breast cancer. JAMA Surg. 2018;153(1):29–36.

    Article  PubMed  Google Scholar 

  16. Katz SJ, Janz NK, Abrahamse P, et al. Patient reactions to surgeon recommendations about contralateral prophylactic mastectomy for treatment of breast cancer. JAMA Surg. 2017;152(7):658–64.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sorbero ME, Dick AW, Beckjord EB, Ahrendt G. Diagnostic breast magnetic resonance imaging and contralateral prophylactic mastectomy. Ann Surg Oncol. 2009;16(6):1597–605.

    Article  PubMed  Google Scholar 

  18. Guth U, Myrick ME, Viehl CT, Weber WP, Lardi AM, Schmid SM. Increasing rates of contralateral prophylactic mastectomy: a trend made in USA? Eur J Surg Oncol. 2012;38(4):296–301.

    Article  CAS  PubMed  Google Scholar 

  19. Porter G, Wagar B, Bryant H, et al. Rates of breast cancer surgery in Canada from 2007/08 to 2009/10: retrospective cohort study. CMAJ Open. 2014;2(2):E102-108.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Roberts A, Sandhu L, Cil TD, Hofer SO, Zhong T. Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center. World J Clin Oncol. 2016;7(3):302–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Metcalfe KA, Lubinski J, Ghadirian P, et al. Predictors of contralateral prophylactic mastectomy in women with a BRCA1 or BRCA2 mutation: the Hereditary Breast Cancer Clinical Study Group. J Clin Oncol. 2008;26(7):1093–7.

    Article  PubMed  Google Scholar 

  22. Abbott A, Rueth N, Pappas-Varco S, Kuntz K, Kerr E, Tuttle T. Perceptions of contralateral breast cancer: an overestimation of risk. Ann Surg Oncol. 2011;18(11):3129–36.

    Article  PubMed  Google Scholar 

  23. Rosenberg SM, Tracy MS, Meyer ME, et al. Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: a cross-sectional survey. Ann Intern Med. 2013;159(6):373–81.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fisher CS, Martin-Dunlap T, Ruppel MB, Gao F, Atkins J, Margenthaler JA. Fear of recurrence and perceived survival benefit are primary motivators for choosing mastectomy over breast-conservation therapy regardless of age. Ann Surg Oncol. 2012;19(10):3246–50.

    Article  PubMed  Google Scholar 

  25. Kwong A, Chu AT. What made her give up her breasts: a qualitative study on decisional considerations for contralateral prophylactic mastectomy among breast cancer survivors undergoing BRCA1/2 genetic testing. Asian Pac J Cancer Prev. 2012;13(5):2241–7.

    Article  PubMed  Google Scholar 

  26. Geiger AM, West CN, Nekhlyudov L, et al. Contentment with quality of life among breast cancer survivors with and without contralateral prophylactic mastectomy. J Clin Oncol. 2006;24(9):1350–6.

    Article  PubMed  Google Scholar 

  27. Graves KD, Peshkin BN, Halbert CH, DeMarco TA, Isaacs C, Schwartz MD. Predictors and outcomes of contralateral prophylactic mastectomy among breast cancer survivors. Breast Cancer Res Treat. 2007;104(3):321–9.

    Article  PubMed  Google Scholar 

  28. Gutnik L, Fayanju OM. Controversies in breast cancer surgery. Surg Clin North Am. 2021;101(6):1033–44.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Scheepens JCC, Veer LV, Esserman L, Belkora J, Mukhtar RA. Contralateral prophylactic mastectomy: a narrative review of the evidence and acceptability. Breast. 2021;56:61–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hodgson DC, Gilbert ES, Dores GM, et al. Long-term solid cancer risk among 5-year survivors of Hodgkin’s lymphoma. J Clin Oncol. 2007;25(12):1489–97.

    Article  PubMed  Google Scholar 

  31. Narod SA, Kharazmi E, Fallah M, Sundquist K, Hemminki K. The risk of contralateral breast cancer in daughters of women with and without breast cancer. Clin Genet. 2016;89(3):332–5.

    Article  CAS  PubMed  Google Scholar 

  32. Reiner AS, Sisti J, John EM, et al. Breast cancer family history and contralateral breast cancer risk in young women: an update from the women’s environmental cancer and radiation epidemiology study. J Clin Oncol. 2018;36(15):1513–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kenny R, Reed M, Subramanian A. Mastectomy for risk reduction or symmetry in women without high risk gene mutation: a review. Int J Surg. 2018;50:60–4.

    Article  CAS  PubMed  Google Scholar 

  34. Yadav S, Boddicker NJ, Na J, et al. Contralateral breast cancer risk among carriers of germline pathogenic variants in ATM, BRCA1, BRCA2, CHEK2, and PALB2. J Clin Oncol. 2023;41(9):1703–13.

    Article  CAS  PubMed  Google Scholar 

  35. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017;317(23):2402–16.

    Article  CAS  PubMed  Google Scholar 

  36. Morra A, Mavaddat N, Muranen TA, et al. The impact of coding germline variants on contralateral breast cancer risk and survival. Am J Hum Genet. 2023;110(3):475–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Krontiras H, Farmer M, Whatley J. Breast Cancer Genetics and Indications for Prophylactic Mastectomy. Surg Clin North Am. 2018;98(4):677–85.

    Article  PubMed  Google Scholar 

  38. Chowdhury M, Euhus D, Onega T, Biswas S, Choudhary PK. A model for individualized risk prediction of contralateral breast cancer. Breast Cancer Res Treat. 2017;161(1):153–60.

    Article  CAS  PubMed  Google Scholar 

  39. Giardiello D, Steyerberg EW, Hauptmann M, et al. Prediction and clinical utility of a contralateral breast cancer risk model. Breast Cancer Res. 2019;21(1):144.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Giardiello D, Hauptmann M, Steyerberg EW, et al. Prediction of contralateral breast cancer: external validation of risk calculators in 20 international cohorts. Breast Cancer Res Treat. 2020;181(2):423–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Braun D, Yang J, Griffin M, Parmigiani G, Hughes KS. A clinical decision support tool to predict cancer risk for commonly tested cancer-related germline mutations. J Genet Couns. 2018;27(5):1187–99.

    Article  PubMed  PubMed Central  Google Scholar 

  42. National Comprehensive Cancer Network. Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (Version 2.2024). Available at: https://www.nccn.org/professionals/physician_gls/pdf/genetics_bop.pdf. Accessed 19 Oct 2023.

  43. Sacks GD, Morrow M. Addressing the dilemma of contralateral prophylactic mastectomy with behavioral science. J Clin Oncol. 2021;39(4):269–72.

    Article  PubMed  Google Scholar 

  44. Arrington AK, Jarosek SL, Virnig BA, Habermann EB, Tuttle TM. Patient and surgeon characteristics associated with increased use of contralateral prophylactic mastectomy in patients with breast cancer. Ann Surg Oncol. 2009;16(10):2697–704.

    Article  PubMed  Google Scholar 

  45. Nichols HB, Berrington de Gonzalez A, Lacey JV, Rosenberg PS, Anderson WF. Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol. 2011;29(12):1564–9.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Giannakeas V, Lim DW, Narod SA. The risk of contralateral breast cancer: a SEER-based analysis. Br J Cancer. 2021;125(4):601–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Reiner AS, John EM, Brooks JD, et al. Risk of asynchronous contralateral breast cancer in noncarriers of BRCA1 and BRCA2 mutations with a family history of breast cancer: a report from the Women’s Environmental Cancer and Radiation Epidemiology Study. J Clin Oncol. 2013;31(4):433–9.

    Article  PubMed  Google Scholar 

  48. Ramin C, Withrow DR, Davis Lynn BC, Gierach GL, Berrington de Gonzalez A. Risk of contralateral breast cancer according to first breast cancer characteristics among women in the USA 1992–2016. Breast Cancer Res. 2021;23(1):24.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Montagna G, Morrow M. Contralateral prophylactic mastectomy in breast cancer: what to discuss with patients. Expert Rev Anticancer Ther. 2020;20(3):159–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Herrinton LJ, Barlow WE, Yu O, et al. Efficacy of prophylactic mastectomy in women with unilateral breast cancer: a cancer research network project. J Clin Oncol. 2005;23(19):4275–86.

    Article  PubMed  Google Scholar 

  51. Peralta EA, Ellenhorn JD, Wagman LD, Dagis A, Andersen JS, Chu DZ. Contralateral prophylactic mastectomy improves the outcome of selected patients undergoing mastectomy for breast cancer. Am J Surg. 2000;180(6):439–45.

    Article  CAS  PubMed  Google Scholar 

  52. Boughey JC, Hoskin TL, Degnim AC, et al. Contralateral prophylactic mastectomy is associated with a survival advantage in high-risk women with a personal history of breast cancer. Ann Surg Oncol. 2010;17(10):2702–9.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Brewster AM, Bedrosian I, Parker PA, et al. Association between contralateral prophylactic mastectomy and breast cancer outcomes by hormone receptor status. Cancer. 2012;118(22):5637–43.

    Article  CAS  PubMed  Google Scholar 

  54. Fayanju OM, Stoll CR, Fowler S, Colditz GA, Margenthaler JA. Contralateral prophylactic mastectomy after unilateral breast cancer: a systematic review and meta-analysis. Ann Surg. 2014;260(6):1000–10.

    Article  PubMed  Google Scholar 

  55. Li X, You R, Wang X, et al. Effectiveness of prophylactic surgeries in BRCA1 or BRCA2 mutation carriers: a meta-analysis and systematic review. Clin Cancer Res. 2016;22(15):3971–81.

    Article  CAS  PubMed  Google Scholar 

  56. Levine DA, Gemignani ML. Prophylactic surgery in hereditary breast/ovarian cancer syndrome. Oncology. 2003;17(7):932–41.

    PubMed  Google Scholar 

  57. Biglia N, D’Alonzo M, Sgro LG, Tomasi Cont N, Bounous V, Robba E. Breast cancer treatment in mutation carriers: surgical treatment. Minerva Ginecol. 2016;68(5):548–56.

    PubMed  Google Scholar 

  58. Bleicher RJ. Timing and delays in breast cancer evaluation and treatment. Ann Surg Oncol. 2018;25(10):2829–38.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Sharabi SE, Baumann DP, Selber JC, et al. Complications of contralateral prophylactic mastectomy: do they delay adjuvant therapy? Plast Reconstr Surg. 2020;146(5):945–53.

    Article  CAS  PubMed  Google Scholar 

  60. Silva AK, Lapin B, Yao KA, Song DH, Sisco M. The effect of contralateral prophylactic mastectomy on perioperative complications in women undergoing immediate breast reconstruction: a NSQIP analysis. Ann Surg Oncol. 2015;22(11):3474–80.

    Article  PubMed  Google Scholar 

  61. Miller ME, Czechura T, Martz B, et al. Operative risks associated with contralateral prophylactic mastectomy: a single institution experience. Ann Surg Oncol. 2013;20(13):4113–20.

    Article  PubMed  Google Scholar 

  62. Osman F, Saleh F, Jackson TD, Corrigan MA, Cil T. Increased postoperative complications in bilateral mastectomy patients compared to unilateral mastectomy: an analysis of the NSQIP database. Ann Surg Oncol. 2013;20(10):3212–7.

    Article  PubMed  Google Scholar 

  63. Momoh AO, Cohen WA, Kidwell KM, et al. Tradeoffs associated with contralateral prophylactic mastectomy in women choosing breast reconstruction: results of a prospective multicenter cohort. Ann Surg. 2017;266(1):158–64.

    Article  PubMed  Google Scholar 

  64. Huang J, Chagpar AB. Quality of life and body image as a function of time from mastectomy. Ann Surg Oncol. 2018;25(10):3044–51.

    Article  PubMed  Google Scholar 

  65. Anderson C, Islam JY, Elizabeth Hodgson M, et al. Long-term satisfaction and body image after contralateral prophylactic mastectomy. Ann Surg Oncol. 2017;24(6):1499–506.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Metcalfe KA, Retrouvey H, Kerrebijn I, et al. Predictors of uptake of contralateral prophylactic mastectomy in women with nonhereditary breast cancer. Cancer. 2019;125(22):3966–73.

    Article  PubMed  Google Scholar 

  67. Hwang ES, Locklear TD, Rushing CN, et al. Patient-reported outcomes after choice for contralateral prophylactic mastectomy. J Clin Oncol. 2016;34(13):1518–27.

    Article  PubMed  Google Scholar 

  68. Parker PA, Peterson SK, Shen Y, et al. Prospective study of psychosocial outcomes of having contralateral prophylactic mastectomy among women with nonhereditary breast cancer. J Clin Oncol. 2018;36(25):2630–8.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Razdan SN, Panchal H, Albornoz CR, et al. Impact of contralateral symmetry procedures on long-term patient-reported outcomes following unilateral prosthetic breast reconstruction. J Reconstr Microsurg. 2019;35(2):124–8.

    Article  PubMed  Google Scholar 

  70. Bitoiu B, Grigor E, Hardy J, Zeitouni C, Arnaout A, Zhang J. Symmetrical breast surgery: balancing procedures versus prophylactic mastectomy and immediate reconstruction. Plast Reconstr Surg. 2023. https://doi.org/10.1097/PRS.0000000000010713.

    Article  PubMed  Google Scholar 

  71. Billig JI, Duncan A, Zhong L, et al. The cost of contralateral prophylactic mastectomy in women with unilateral breast cancer. Plast Reconstr Surg. 2018;141(5):1094–102.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Schroeder MC, Tien YY, Erdahl LM, Lizarraga IM, Viyyuri BR, Sugg SL. The relationship between contralateral prophylactic mastectomy and breast reconstruction, complications, breast-related procedures, and costs: a population-based study of health insurance data. Surgery. 2020;168(5):859–67.

    Article  PubMed  Google Scholar 

  73. Ha M, Ngaage LM, Klein M, et al. Contralateral prophylactic mastectomy in the setting of breast cancer diagnosis and their insurance coverage in the United States. Breast J. 2021;27(10):746–52.

    Article  PubMed  Google Scholar 

  74. Nealon KP, Sobti N, Gadd M, Specht M, Liao EC. Assessing the additional surgical risk of contralateral prophylactic mastectomy and immediate breast implant reconstruction. Breast Cancer Res Treat. 2020;179(2):255–65.

    Article  PubMed  Google Scholar 

  75. Murphy AI, Asadourian PA, Mellia JA, Rohde CH. Complications associated with contralateral prophylactic mastectomy: a systematic review and meta-analysis. Plast Reconstr Surg. 2022;150:61S-72S.

    Article  CAS  PubMed  Google Scholar 

  76. Tait RC, Zoberi K, Ferguson M, et al. Persistent post-mastectomy pain: risk factors and current approaches to treatment. J Pain. 2018;19(12):1367–83.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Alves Nogueira Fabro E, Bergmann A, do Amaral ESB, et al. Post-mastectomy pain syndrome: incidence and risks. Breast. 2012;21(3):321–5.

    Article  PubMed  Google Scholar 

  78. Carpenter JS, Andrykowski MA, Sloan P, et al. Postmastectomy/postlumpectomy pain in breast cancer survivors. J Clin Epidemiol. 1998;51(12):1285–92.

    Article  CAS  PubMed  Google Scholar 

  79. Gartner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA. 2009;302(18):1985–92.

    Article  PubMed  Google Scholar 

  80. Peuckmann V, Ekholm O, Rasmussen NK, et al. Chronic pain and other sequelae in long-term breast cancer survivors: nationwide survey in Denmark. Eur J Pain. 2009;13(5):478–85.

    Article  CAS  PubMed  Google Scholar 

  81. Stevens PE, Dibble SL, Miaskowski C. Prevalence, characteristics, and impact of postmastectomy pain syndrome: an investigation of women’s experiences. Pain. 1995;61(1):61–8.

    Article  PubMed  Google Scholar 

  82. Tasmuth T, von Smitten K, Hietanen P, Kataja M, Kalso E. Pain and other symptoms after different treatment modalities of breast cancer. Ann Oncol. 1995;6(5):453–9.

    Article  CAS  PubMed  Google Scholar 

  83. Vilholm OJ, Cold S, Rasmussen L, Sindrup SH. The postmastectomy pain syndrome: an epidemiological study on the prevalence of chronic pain after surgery for breast cancer. Br J Cancer. 2008;99(4):604–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Akdeniz Dogan Z, Farhadi J. Evaluation of sensation on mastectomy skin flaps following immediate breast reconstruction. J Reconstr Microsurg. 2020;36(6):420–5.

    Article  PubMed  Google Scholar 

  85. Rodriguez-Unda NA, Bello RJ, Clarke-Pearson EM, et al. Nipple-sparing mastectomy improves long-term nipple but not skin sensation after breast reconstruction: quantification of long-term sensation in nipple sparing versus non-nipple sparing mastectomy. Ann Plast Surg. 2017;78(6):697–703.

    Article  CAS  PubMed  Google Scholar 

  86. Dossett LA, Lowe J, Sun W, et al. Prospective evaluation of skin and nipple-areola sensation and patient satisfaction after nipple-sparing mastectomy. J Surg Oncol. 2016;114(1):11–6.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Rolnick SJ, Altschuler A, Nekhlyudov L, et al. What women wish they knew before prophylactic mastectomy. Cancer Nurs. 2007;30(4):285–91.

    Article  PubMed  Google Scholar 

  88. King TA, Gurevich I, Sakr R, Patil S, Stempel M, Morrow M. Occult malignancy in patients undergoing contralateral prophylactic mastectomy. Ann Surg. 2011;254(1):2–7.

    Article  PubMed  Google Scholar 

  89. Boughey JC, Khakpour N, Meric-Bernstam F, et al. Selective use of sentinel lymph node surgery during prophylactic mastectomy. Cancer. 2006;107(7):1440–7.

    Article  PubMed  Google Scholar 

  90. Nasser SM, Smith SG, Chagpar AB. The role of sentinel node biopsy in women undergoing prophylactic mastectomy. J Surg Res. 2010;164(2):188–92.

    Article  PubMed  Google Scholar 

  91. Black D, Specht M, Lee JM, et al. Detecting occult malignancy in prophylactic mastectomy: preoperative MRI versus sentinel lymph node biopsy. Ann Surg Oncol. 2007;14(9):2477–84.

    Article  PubMed  Google Scholar 

  92. Boughey JC, Cormier JN, Xing Y, et al. Decision analysis to assess the efficacy of routine sentinel lymphadenectomy in patients undergoing prophylactic mastectomy. Cancer. 2007;110(11):2542–50.

    Article  PubMed  Google Scholar 

  93. Laronga C, Lee MC, McGuire KP, et al. Indications for sentinel lymph node biopsy in the setting of prophylactic mastectomy. J Am Coll Surg. 2009;209(6):746–52.

    Article  PubMed  Google Scholar 

  94. Nagaraja V, Edirimanne S, Eslick GD. Is sentinel lymph node biopsy necessary in patients undergoing prophylactic mastectomy? A systematic review and meta-analysis. Breast J. 2016;22(2):158–65.

    Article  PubMed  Google Scholar 

  95. Wong SM, Ferroum A, Apostolova C, et al. Incidence of occult breast cancer in carriers of BRCA1/2 or other high-penetrance pathogenic variants undergoing prophylactic mastectomy: when is sentinel lymph node biopsy indicated? Ann Surg Oncol. 2022;29(11):6660–8.

    Article  PubMed  Google Scholar 

  96. Thompson JL, Sinco BR, McCaffrey RL, et al. Prophylactic mastectomy and occult malignancy: surgical and imaging considerations. J Surg Oncol. 2023;127(1):18–27.

    Article  PubMed  Google Scholar 

  97. Madan V, Mamounas EP. Is sentinel lymph node biopsy necessary in patients who undergo prophylactic mastectomy? Clin Breast Cancer. 2023;23(2):231–6.

    Article  PubMed  Google Scholar 

  98. McLaughlin SA, Stempel M, Morris EA, Liberman L, King TA. Can magnetic resonance imaging be used to select patients for sentinel lymph node biopsy in prophylactic mastectomy? Cancer. 2008;112(6):1214–21.

    Article  PubMed  Google Scholar 

  99. Freitas V, Crystal P, Kulkarni SR, et al. The value of breast MRI in high-risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: is there a role to choose wisely patients for sentinel node biopsy? Cancer Med. 2016;5(6):1031–6.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Czyszczon IA, Roland L, Sahoo S. Routine prophylactic sentinel lymph node biopsy is not indicated in women undergoing prophylactic mastectomy. J Surg Oncol. 2012;105(7):650–4.

    Article  PubMed  Google Scholar 

  101. Karakatsanis A, Eriksson S, Pistiolis L, et al. Delayed sentinel lymph node dissection in patients with a preoperative diagnosis of ductal cancer in situ by preoperative injection with superparamagnetic iron oxide (SPIO) nanoparticles: the SentiNot study. Ann Surg Oncol. 2023;30(7):4064–72.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Susnik B, Schneider L, Swenson KK, et al. Predictive value of breast magnetic resonance imaging in detecting mammographically occult contralateral breast cancer: can we target women more likely to have contralateral breast cancer? J Surg Oncol. 2018;118(1):221–7.

    Article  PubMed  Google Scholar 

  103. Wu WP, Chen CY, Lee CW, et al. Impact of pre-operative breast magnetic resonance imaging on contralateral synchronous and metachronous breast cancer detection-A case control comparison study with 1468 primary operable breast cancer patients with mean follow-up of 102 months. PLoS One. 2021;16(11):e0260093.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Erdahl LM, Boughey JC, Hoskin TL, Degnim AC, Hieken TJ. Contralateral prophylactic mastectomy: factors predictive of occult malignancy or high-risk lesion and the impact of MRI and genetic testing. Ann Surg Oncol. 2016;23(1):72–7.

    Article  PubMed  Google Scholar 

  105. Brennan ME, Houssami N, Lord S, et al. Magnetic resonance imaging screening of the contralateral breast in women with newly diagnosed breast cancer: systematic review and meta-analysis of incremental cancer detection and impact on surgical management. J Clin Oncol. 2009;27(33):5640–9.

    Article  PubMed  Google Scholar 

  106. Houssami N, Turner R, Macaskill P, et al. An individual person data meta-analysis of preoperative magnetic resonance imaging and breast cancer recurrence. J Clin Oncol. 2014;32(5):392–401.

    Article  PubMed  Google Scholar 

  107. Killelea BK, Long JB, Chagpar AB, et al. Trends and clinical implications of preoperative breast MRI in Medicare beneficiaries with breast cancer. Breast Cancer Res Treat. 2013;141(1):155–63.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Miller BT, Abbott AM, Tuttle TM. The influence of preoperative MRI on breast cancer treatment. Ann Surg Oncol. 2012;19(2):536–40.

    Article  PubMed  Google Scholar 

  109. Houssami N, Turner RM, Morrow M. Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer. Breast Cancer Res Treat. 2017;165(2):273–83.

    Article  PubMed  PubMed Central  Google Scholar 

  110. Hlubocky J, Bhavnagri S, Swinford A, Mitri C, Rebner M, Pai V. Does the use of pretreatment MRI change the management of patients with newly diagnosed breast cancer? Breast J. 2018;24(3):309–13.

    Article  PubMed  Google Scholar 

  111. Lehman CD, Gatsonis C, Kuhl CK, et al. MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 2007;356(13):1295–303.

    Article  CAS  PubMed  Google Scholar 

  112. Chandwani S, George PA, Azu M, et al. Role of preoperative magnetic resonance imaging in the surgical management of early-stage breast cancer. Ann Surg Oncol. 2014;21(11):3473–80.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Houssami N, Turner R, Morrow M. Preoperative magnetic resonance imaging in breast cancer: meta-analysis of surgical outcomes. Ann Surg. 2013;257(2):249–55.

    Article  PubMed  Google Scholar 

  114. Landercasper J, Bailey L, Berry TS, et al. Measures of appropriateness and value for breast surgeons and their patients: the American society of breast surgeons choosing Wisely® initiative. Ann Surg Oncol. 2016;23(10):3112–8.

    Article  PubMed  PubMed Central  Google Scholar 

  115. The American Society of Breast Surgeons. Consensus Guideline on Diagnostic and Screening Magnetic Resonance Imaging of the Breast. Published 2017. Available at: https://www.breastsurgeons.org/docs/statements/Consensus-Guideline-on-Diagnostic-and-Screening-Magnetic-Resonance-Imaging-of-the-Breast.pdf. Accessed 19 Oct 2023.

  116. Patel BK, Lee CS, Kosiorek HE, Newell MS, Pizzitola VJ, D’Orsi CJ. Variability of postsurgical imaging surveillance of breast cancer patients: a nationwide survey study. AJR Am J Roentgenol. 2018;210(1):222–7.

    Article  PubMed  Google Scholar 

  117. Ahn S, Elnekaveh B, Schmidt H, Weltz C, Pisapati K, Port E. Defining the need for imaging and biopsy after mastectomy. Ann Surg Oncol. 2018;25(13):3843–8.

    Article  PubMed  Google Scholar 

  118. Noroozian M, Carlson LW, Savage JL, et al. Use of screening mammography to detect occult malignancy in autologous breast reconstructions: a 15-year experience. Radiology. 2018;289(1):39–48.

    Article  PubMed  Google Scholar 

  119. Golan O, Amitai Y, Barnea Y, Menes TS. Yield of surveillance magnetic resonance imaging after bilateral mastectomy and reconstruction: a retrospective cohort study. Breast Cancer Res Treat. 2019;174(2):463–8.

    Article  PubMed  Google Scholar 

  120. Shammas RL, Broadwater G, Cason RW, et al. Assessing the utility of post-mastectomy imaging after breast reconstruction. J Am Coll Surg. 2020;230(4):605-614 e601.

    Article  PubMed  Google Scholar 

  121. Bucchi L, Belli P, Benelli E, et al. Recommendations for breast imaging follow-up of women with a previous history of breast cancer: position paper from the Italian Group for Mammography Screening (GISMa) and the Italian College of Breast Radiologists (ICBR) by SIRM. Radiol Med. 2016;121(12):891–6.

    Article  PubMed  PubMed Central  Google Scholar 

  122. Kanana N, Ben David MA, Nissan N, et al. Post-mastectomy surveillance of BRCA1/BRCA2 mutation carriers: outcomes from a specialized clinic for high-risk breast cancer patients. Breast J. 2021;27(5):441–7.

    Article  CAS  PubMed  Google Scholar 

  123. Lee CN, Merrill AL, Peters E. The role of emotion in cancer surgery decisions: applying concepts from decision psychology. Ann Surg. 2021;273(6):e265–7.

    Article  PubMed  Google Scholar 

  124. Silverstein MC, Lee CN, Scherer LD, Phommasathit C, Merrill AL, Peters E. Operating on anxiety: negative affect toward breast cancer and choosing contralateral prophylactic mastectomy. Med Decis Making. 2023;43(2):152–63.

    Article  PubMed  Google Scholar 

  125. Hawley ST, Griffith KA, Hamilton AS, et al. The association between patient attitudes and values and the strength of consideration for contralateral prophylactic mastectomy in a population-based sample of breast cancer patients. Cancer. 2017;123(23):4547–55.

    Article  PubMed  Google Scholar 

  126. Schmidt MK, Kelly JE, Bredart A, et al. EBCC-13 manifesto: balancing pros and cons for contralateral prophylactic mastectomy. Eur J Cancer. 2023;181:79–91.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Puneet Singh MD, MS

  2. The Ohio State University, Columbus, OH, USA

    Doreen Agnese MD

  3. Private Practice, Southlake, TX, USA

    Miral Amin MD

  4. Memorial Sloan Kettering Cancer Center, New York City, NY, USA

    Andrea V. Barrio MD

  5. Duke University Medical Center, Durham, NC, USA

    Astrid Botty Van den Bruele MD & Jennifer K. Plichta MD, MS

  6. University of Kentucky, Lexington, KY, USA

    Erin Burke MD

  7. Chevy Chase, MD, USA

    David N. Danforth Jr. MD

  8. Stanford University School of Medicine, Stanford, CA, USA

    Frederick M. Dirbas MD

  9. Rutgers Cancer Institute of New Jersey, Hamilton, NJ, USA

    Firas Eladoumikdachi MD

  10. Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Olga Kantor MD & Ko Un Park MD

  11. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Shicha Kumar MD

  12. Moffitt Cancer Center, Tampa, FL, USA

    Marie Catherine Lee MD & Christine Laronga MD

  13. University of Utah, Salt Lake City, UT, USA

    Cindy Matsen MD

  14. Lakeland Regional Health, Lakeland, FL, USA

    Toan T. Nguyen MD

  15. Massachusetts General Hospital, Boston, MA, USA

    Tolga Ozmen MD

  16. Loyola University, Chicago, IL, USA

    Chantal Reyna MD

  17. University of Virginia, Charlottesville, VA, USA

    Shayna L. Showalter MD

  18. Emory University, Atlanta, GA, USA

    Toncred Styblo MD

  19. Broward Surgical Associates, Fort Lauderdale, FL, USA

    Nicholas Tranakas MD

  20. University of Rochester Medical Center, Rochester, NY, USA

    Anna Weiss MD

  21. Mayo Clinic, Rochester, MN, USA

    Judy Boughey MD

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Corresponding author

Correspondence to Puneet Singh MD, MS.

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Disclosure

Jennifer K. Plichta received a research grant from the non-profit Earlier.org in 2023. Chantal Reyna was a Consultant for Agendia and Elucent Medical in the past 24 months; agreements terminated December 2022. Anna Weiss discloses she was a member of the advisory board for Merck and received consultant fees from Myriad. Christine Laronga discloses Up-To-Date royalties for editing the DCIS section. Frederick M. Dirbas is a shareholder for Hologic Inc. Puneet Singh, Doreen Agnese, Miral Amin, Andrea V. Barrio, Astrid Botty van den Bruele, Erin Burke, David N. Danforth Jr, Firas Eladoumikdachi, Olga Kantor, Shicha Kumar, Marie Catherine Lee, Cindy Matsen, Toan T. Nguyen, Tolga Ozmen, Ko Un Park, Shayna L. Showalter, Toncred Styblo, Nicholas Tranakas, and Judy Boughey have no conflicts of interest to declare in relation to this work.

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David N. Danforth Jr—retired.

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Singh, P., Agnese, D., Amin, M. et al. Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks. Ann Surg Oncol 31, 2212–2223 (2024). https://doi.org/10.1245/s10434-024-14893-x

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