mastectomy
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Introduction
Excision (removal) or the breast
Indications
- treatment of breast cancer
- prophylactic contralateral mastectomy
- BRCA1/BRCA2 genotyping positive
- a genetic mutation of BRCA1 or BRCA2 or another known mutation
- a strong family history of breast cancer
- at least 2 first-degree relatives with breast cancer or ovarian cancer with no demonstrable mutations
- BRCA1/BRCA2 genotyping positive
Contraindications
- mastectomy does not significantly improve survival for younger women (< 40-45 years) with high-risk locoregionally advanced breast cancer*[9]
* tumor pathology & response to systemic therapy are the only significant determinants of survival[9]
Management
- breast reconstruction after mastectomy facilitated by the use of breast implants[3]
- some reconstruction techniques use autologous tissue[3]
- nipple-sparing mastectomy with similar overall & disease-free survival to total mastectomy[8]
Notes
- young women with unilateral breast cancer who elect for prophylactic bilateral mastectomy overestimate risk[2]
- increasing despite lack of survival benefit or prevention of metastatic recurrence[6]
- 31% of women who elect contralateral prophylactic mastectomy have a clinical indication for the procedure[4]
- women with early-stage breast cancer who are eligible for breast conservation surgery are increasingly opting for mastectomy[5]
More general terms
More specific terms
References
- ↑ Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
- ↑ 2.0 2.1 Rosenberg SM 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):373-381 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/24042365 <Internet> http://annals.org/article.aspx?articleid=1738492
Portschy PR and Tuttle TM Contralateral Prophylactic Mastectomy: Perceptions Versus Reality. Ann Intern Med. 2013;159(6):428-429 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/24042370 <Internet> http://annals.org/article.aspx?articleid=1738497 - ↑ 3.0 3.1 3.2 Jagsi R et al. Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States. J Clin Oncol 2014 Feb 18 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/24550418 <Internet> http://jco.ascopubs.org/content/early/2014/02/18/JCO.2013.52.2284
- ↑ 4.0 4.1 Hawley ST et al Social and Clinical Determinants of Contralateral Prophylactic Mastectomy. JAMA Surg. Published online May 21, 2014 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/24849045 <Internet> http://archsurg.jamanetwork.com/article.aspx?articleid=1873911
- ↑ 5.0 5.1 Kummerow KL et al Nationwide Trends in Mastectomy for Early-Stage Breast Cancer. JAMA Surg. Published online November 19, 2014 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/25408966 <Internet> http://archsurg.jamanetwork.com/article.aspx?articleid=1921808
Sun B, Zenilman ME The Swinging Pendulum. JAMA Surg. Published online November 19, 2014 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/25409114 <Internet> http://archsurg.jamanetwork.com/article.aspx?articleid=1921805 - ↑ 6.0 6.1 Jagsi R, Hawley ST, Griffith KA et al. Contralateral prophylactic mastectomy decisions in a population- based sample of patients with early-stage breast cancer. JAMA Surg 2017 Mar 1; 152:274 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/28002555 <Internet> http://jamanetwork.com/journals/jamasurgery/article-abstract/2593807
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 Apr 5. PMID: https://pubmed.ncbi.nlm.nih.gov/28384687 - ↑ Ramaswami R, Morrow M, Jagsi R. Contralateral Prophylactic Mastectomy. N Engl J Med 2017; 377:1288-1291. September 28, 2017 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/28953446 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMclde1708293
- ↑ 8.0 8.1 Coffey S Large Analysis Confirms Safety of Nipple-Sparing Mastectomy. Medscape, December 02, 2021 https://www.medscape.com/viewarticle/964017
Fu M, Chen Q, Zwng L et al Prognosis Comparison Between Nipple-Sparing Mastectomy and Total Mastectomy in Breast Cancer: A Case-Control Study After Propensity Score Matching. Ann Surg Oncol 2021. Nov 20 PMID: https://pubmed.ncbi.nlm.nih.gov/34802105 https://link.springer.com/article/10.1245/s10434-021-11044-4 - ↑ 9.0 9.1 9.2 Bankhead C No Survival Benefit With Mastectomy in Younger, High-Risk Breast Cancer. Higher tumor grade, more residual tumor after neoadjuvant therapy were only significant factors. MedPage Today. May 4, 2026 https://www.medpagetoday.com/hematologyoncology/breastcancer/121092