HOUSTON — The Journal of the National Cancer Institute published online a groundbreaking study this week co-written by Dr. Isabelle Bedrossian, about contralateral prophylactic mastectomy (CPM), a preventive procedure to remove the unaffected breast in patients with disease in one breast. CPM may only offer a survival benefit to breast cancer patients age 50 and younger, who have early-stage disease and are estrogen receptor (ER) negative, according to researchers at The University of Texas MD Anderson Cancer Center.
This is the first population-based study to find an association between the procedure and survival in any group of breast cancer patients. The findings should offer evidence to both the women making this often agonizing decision and the physicians responsible for their care.
Bedrosian, assistant professor in M.D. Anderson’s Department of Surgical Oncology, said that a growing number of breast cancer patients are opting for the procedure; recent statistics have shown that the rate of CPM in women with stage I-III breast cancer increased by 150 percent from 1998 to 2003 in the United States.
“In our clinic, we’ve seen a dramatic increase in the number of women requesting CPM, and across the breast cancer community, studies have shown that the utilization of the procedure is skyrocketing,” said Bedrosian. “Until now, we’ve counseled these patients on a very important, personal decision in a vacuum. With our study, our goal was to understand the implications of the surgery and who may benefit.”
Rigorous analysis was paramount in the design of the study, said George J.
Chang, MD, assistant professor at the same hospital. “It was important to take a critical eye and look at all the different ways the data could be misinterpreted to ensure that biases were not impacting our findings,” said Chang, the study’s co-corresponding author.