Surgeons’ Perspectives of Contralateral Prophylactic Mastectomy

Emily Bellavance, Jeffrey Peppercorn, Shari Kronsberg, Rachel Greenup, Jason Keune, Julie Lynch, Deborah Collyar, Laurence Magder, Jon C Tilburt, Fay Hlubocky, Katharine Yao

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Contralateral prophylactic mastectomy (CPM) is commonly performed for the treatment of breast cancer, despite its limited oncologic benefit. Little is known about surgeons’ perceptions of performing CPM. We hypothesized that a proportion of surgeons would report discomfort with performing CPM, particularly when there is discordance between patients’ perceived benefit from CPM and the expected oncologic benefit. Methods: A survey was sent to members of the American Society of Breast Surgeons seeking self-reports of surgeons’ practice patterns, perceptions, and comfort levels with CPM. Results: Of the 2436 members surveyed, 601 responded (response rate = 24.7 %). The median age of respondents was 52 years, and 59 % of responders were women. The majority (58 %) reported that 80 % of their practice was devoted to the treatment of breast disease. Fifty-seven percent (n = 326) of respondents reported discomfort with performing CPM at some point in their practice. While most surgeons (95 %) were comfortable with CPM on a patient with a deleterious BRCA mutation, only 34 % were comfortable performing CPM on an average-risk patient. The most common reasons reported for surgeon discomfort with CPM were a concern for overtreatment, an unfavorable risk/benefit ratio, and inadequate patient understanding of the anticipated risks and benefits of CPM. Conclusions: Despite the increasing use of CPM for the treatment of breast cancer, many surgeons report discomfort with CPM. Concerns with performing CPM predominantly focus on ambiguities surrounding the oncologic benefit and relative risk of this procedure. Further research is needed to define optimal shared decision-making practices in this area.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - May 11 2016

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Surgeons
Prophylactic Mastectomy
Breast Neoplasms
Breast Diseases
Self Report
Decision Making
Therapeutics
Odds Ratio
Mutation
Research
Surveys and Questionnaires
Medical Overuse

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Bellavance, E., Peppercorn, J., Kronsberg, S., Greenup, R., Keune, J., Lynch, J., ... Yao, K. (Accepted/In press). Surgeons’ Perspectives of Contralateral Prophylactic Mastectomy. Annals of Surgical Oncology, 1-9. https://doi.org/10.1245/s10434-016-5253-9

Surgeons’ Perspectives of Contralateral Prophylactic Mastectomy. / Bellavance, Emily; Peppercorn, Jeffrey; Kronsberg, Shari; Greenup, Rachel; Keune, Jason; Lynch, Julie; Collyar, Deborah; Magder, Laurence; Tilburt, Jon C; Hlubocky, Fay; Yao, Katharine.

In: Annals of Surgical Oncology, 11.05.2016, p. 1-9.

Research output: Contribution to journalArticle

Bellavance, E, Peppercorn, J, Kronsberg, S, Greenup, R, Keune, J, Lynch, J, Collyar, D, Magder, L, Tilburt, JC, Hlubocky, F & Yao, K 2016, 'Surgeons’ Perspectives of Contralateral Prophylactic Mastectomy', Annals of Surgical Oncology, pp. 1-9. https://doi.org/10.1245/s10434-016-5253-9
Bellavance E, Peppercorn J, Kronsberg S, Greenup R, Keune J, Lynch J et al. Surgeons’ Perspectives of Contralateral Prophylactic Mastectomy. Annals of Surgical Oncology. 2016 May 11;1-9. https://doi.org/10.1245/s10434-016-5253-9
Bellavance, Emily ; Peppercorn, Jeffrey ; Kronsberg, Shari ; Greenup, Rachel ; Keune, Jason ; Lynch, Julie ; Collyar, Deborah ; Magder, Laurence ; Tilburt, Jon C ; Hlubocky, Fay ; Yao, Katharine. / Surgeons’ Perspectives of Contralateral Prophylactic Mastectomy. In: Annals of Surgical Oncology. 2016 ; pp. 1-9.
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AU - Keune, Jason

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AU - Collyar, Deborah

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