title: Contralateral risk-reducing mastectomy in sporadic breast cancer.
abstract: Recent studies have shown that the number of women undergoing risk-reducing mastectomy has increased rapidly in the USA in the past 15 years. Although a small rise in the number of bilateral risk-reducing procedures has been noted in high-risk gene mutation carriers who have never had breast cancer, this number does not account for the overall increase in procedures undertaken. In patients who have been treated for a primary cancer and are judged to be at high risk of a contralateral breast cancer, contralateral risk-reducing mastectomy is often, but not universally, indicated. However, many patients undergoing contralateral risk-reducing mastectomy might not be categorised as high risk and therefore any potential benefit from this procedure is unproven. At a time when breast-conserving surgery has become more widely used, this sharp increase in contralateral risk-reducing mastectomy is surprising. We have reviewed the literature in an attempt to establish what is driving the increase in this procedure in moderate-to-low-risk populations and to assess its justification in terms of risk-benefit analysis.
authors.affiliation: Nightingale Breast Unit, University Hospital South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Murphy
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Milner
authors.forename: Joseph M
authors.initials: JM
authors.lastname: O'Donoghue
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D015412:Mastectomy, Segmental; D040242:Risk Reduction Behavior