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Contralateral Prophylactic Mastectomy is Associated with a Survival Advantage in High-Risk Women with a Personal History of Breast Cancer

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

Abstract

Background

The aim of this study was to investigate whether contralateral prophylactic mastectomy (CPM) in addition to therapeutic mastectomy (TM) is associated with a survival advantage in high-risk women with breast cancer.

Methods

A total of 385 women with stage I or II breast cancer and a family history of breast cancer who underwent TM and CPM between 1971 and 1993 were evaluated and compared to 385 patients matched on age at diagnosis, tumor stage, nodal status, and year of diagnosis who underwent TM-only. Contralateral breast cancer (CBC) events and survival outcomes were compared.

Results

At a median follow-up of 17.3 years, 2 CBCs (0.5%) developed in the CPM cohort and 31 (8.1%) in the TM-only cohort, representing a 95% decreased risk of CBC (hazard ratio [HR] = 0.05, 95% confidence interval [95% CI] 0.01–0.22, P < 0.0001). One hundred twenty-eight women in the CPM group and 162 women in the TM-only group have died, resulting in 10-year overall survival estimates of 83 and 74%, respectively (HR 0.68, 95% CI 0.54–0.86, P = 0.001). This difference in overall survival persisted in multivariate analysis (HR 0.77, P = 0.03). Disease-free survival (DFS) was better in the CPM cohort than the TM-only group (HR 0.66, 95% CI 0.53–0.82, P = 0.0002) and remained significant in multivariate analysis (HR 0.67, P = 0.0005).

Conclusions

In this retrospective cohort study, CPM was associated with decreased CBC event and improved overall survival and disease free survival.

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Acknowledgment

This work was supported in part by grants from the Department of Defense (DAMD17-94-J-4216) and the National Cancer Institute (U10 CA 37404 and R01 CA80181).

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic College of Medicine, Mayo Clinic Cancer Center, 200 First Street, SW, Rochester, MN, USA

    Judy C. Boughey MD & Amy C. Degnim MD

  2. Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA

    Tanya L. Hoskin MS

  3. Department of Cancer Control, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Thomas A. Sellers PhD

  4. Cancer Center, Mayo Clinic Cancer Center, Rochester, MN, USA

    Joanne L. Johnson RN, Melanie J. Kasner LPN & Marlene H. Frost PhD

  5. Department of Medical Oncology, Mayo Clinic College of Medicine, Mayo Clinic Cancer Center, Rochester, MN, USA

    Lynn C. Hartmann MD

Authors
  1. Judy C. Boughey MD
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  2. Tanya L. Hoskin MS
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  3. Amy C. Degnim MD
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  4. Thomas A. Sellers PhD
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  5. Joanne L. Johnson RN
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  6. Melanie J. Kasner LPN
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  7. Lynn C. Hartmann MD
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  8. Marlene H. Frost PhD
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Corresponding author

Correspondence to Judy C. Boughey MD.

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Boughey, J.C., Hoskin, T.L., Degnim, A.C. 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 17, 2702–2709 (2010). https://doi.org/10.1245/s10434-010-1136-7

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  • DOI: https://doi.org/10.1245/s10434-010-1136-7

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