Details

Autor(en) / Beteiligte

• Wright, Frances C
• Look Hong, Nicole J
• Quan, May Lynn
• Beyfuss, Kaitlyn
• Temple, Sara
• Covelli, Andrea
• Baxter, Nancy
• Gagliardi, Anna R

Titel

Indications for Contralateral Prophylactic Mastectomy: A Consensus Statement Using Modified Delphi Methodology

Ist Teil von

• Annals of surgery, 2018-02, Vol.267 (2), p.271-279

Ort / Verlag

United States: Copyright Wolters Kluwer Health, Inc. All rights reserved

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• OBJECTIVE:To reach a consensus about contralateral prophylactic mastectomy in unilateral breast cancer. SUMMARY BACKGROUND DATA:There has been a substantial increase in the number of North American women with unilateral breast cancer undergoing a therapeutic mastectomy and a contralateral prophylactic mastectomy (CPM) either simultaneously or sequentially. The purpose of this project was to create a nationally endorsed consensus statement for CPM in women with unilateral breast cancer using modified Delphi consensus methodology. METHODS:A nationally representative expert panel of 19 general surgeons, 2 plastic surgeons, 2 medical oncologists, 2 radiation oncologists, and 1 psychologist was invited to participate in the generation of a consensus statement. Thirty-nine statements were created in 5 topic domainspredisposing risk factors for breast cancer, tumor factors, reconstruction/symmetry issues, patient factors, and miscellaneous factors. Panelists were asked to rate statements on a 7-point Likert scale. Two electronic rounds of iterative rating and feedback were anonymously completed, followed by an in-person meeting. Consensus was reached when there was at least 80% agreement. RESULTS:Our panelists did not recommend for average risk women with unilateral breast cancer. The panel recommended CPM for women with a unilateral breast cancer and previous Mantle field radiation or a BrCa1/2 gene mutation. The panel agreed that CPM could be considered by the surgeon on an individual basis forwomen with unilateral breast cancer and a genetic mutation in the CHEK2/PTEN/p53/PALB2/CDH1 gene, and in women who may have significant difficulty achieving symmetry after unilateral mastectomy. CONCLUSION:Contralateral prophylactic mastectomy is rarely recommended for women with unilateral breast cancer.