Having breast cancer in one breast increases a woman's chances of getting breast cancer in the second breast at some point in her lifetime. A study in the March issue of Cancer addresses a question which women facing mastectomy for breast cancer have been asking doctors for years.... should I have my other ("good") breast removed as well to decrease my risk of future breast cancer in the other breast? Here's the study abstract....
"Predictors of contralateral breast cancer in patients with unilateral breast cancer undergoing contralateral prophylactic mastectomy."
Min Yi, Funda Meric-Bernstam, Lavinia P. Middleton, et al. CANCER Print Issue Date: March 1, 2009
Although contralateral prophylactic mastectomy (CPM) reduced the risk of contralateral breast cancer in unilateral breast cancer patients, it was difficult to predict which patients were most likely to benefit from the procedure. The objective of this study was to identify the clinicopathologic factors that predict contralateral breast cancer and thereby inform decisions regarding performing CPM in unilateral breast cancer patients.
A total of 542 unilateral breast cancer patients who underwent CPM at The University of Texas M. D. Anderson Cancer Center from January 2000 to April 2007 were included in the current study. A logistic regression analysis was used to identify clinicopathologic factors that predict contralateral breast cancer.
Of the 542 patients included in this study, 25 (5%) had an occult malignancy in the contralateral breast. Eighty-two patients (15%) had moderate-risk to high-risk histologic findings identified at final pathologic evaluation of the contralateral breast. Multivariate analysis revealed that 3 independent factors predicted malignancy in the contralateral breast: an ipsilateral invasive lobular histology, an ipsilateral multicentric tumor, and a 5-year Gail risk 1.67%. Multivariate analysis also revealed that an age 50 years at the time of the initial cancer diagnosis and an additional ipsilateral moderate-risk to high-risk pathology were independent predictors of moderate-risk to high-risk histologic findings in the contralateral breast.
The findings indicated that CPM may be a rational choice for breast cancer patients who have a 5-year Gail risk 1.67%, an additional ipsilateral moderate-risk to high-risk pathology, an ipsilateral multicentric tumor, or an ipsilateral tumor of invasive lobular histology.
Dr Chrysopoulo is a board certified plastic surgeon specializing in "natural" breast reconstruction surgery after mastectomy using the patient's own tissue (including DIEP flap reconstruction). PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest news in breast reconstruction surgery and research at The Breast Cancer Reconstruction Blog.