title: Increasing trend of contralateral prophylactic mastectomy: what are the factors behind this phenomenon?
abstract: BACKGROUND
  Numerous studies have shown a trend towards increasing rates of contralateral prophylactic mastectomy (CPM) in the US. In this review, we will explore the trend, possible causative factors and outcomes from CPM.
  
  
  METHODS
  We performed a literature review of all relevant retrospective reviews, clinical trials and review articles regarding contralateral prophylactic mastectomy.
  
  
  RESULTS
  Several studies have noted a four to fivefold increase in CPM in recent years; an increase most notable in younger patients. When surveyed, patients report that the most important factors affecting their choice of CPM include fear of cancer recurrence, genetic counseling/testing, family history or additional high risk factors, stress surrounding close follow up, the availability of reconstructive surgery and information provided about contralateral breast cancer (CBC) risk and risk for local recurrence. Women who have undergone CPM do report high satisfaction with the procedure and some studies suggest risk reduction.
  
  
  CONCLUSIONS
  CPM rates have increased across the US and numerous factors have been reported to increase the likelihood of choosing CPM. Despite that bilateral mastectomy is associated with an increased risk of wound and overall postoperative complications for certain populations, this surgery appears to have psychological, cosmetic and possibly oncologic benefit.
authors.affiliation: Surgical Oncology Department, Breast Program, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA. Electronic address: asoran65@gmail.com.
authors.forename: Atilla
authors.initials: A
authors.lastname: Soran
authors.affiliation: Surgical Oncology Department, Breast Program, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.
authors.forename: Ayfer
authors.initials: A
authors.lastname: Kamali Polat
authors.affiliation: Surgical Oncology Department, Breast Program, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Johnson
authors.affiliation: Surgical Oncology Department, Breast Program, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.
authors.forename: Kandace P
authors.initials: KP
authors.lastname: McGuire
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods / Q000639:trends*; D008875:Middle Aged; D012307:Risk Factors
keywords: Breast cancer; Contralateral; Prophylactic mastectomy; Risk reduction