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Invited Commentary
December 21, 2016

Contralateral Prophylactic MastectomyAligning Patient Preferences and Provider Recommendations

Author Affiliations
  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina
JAMA Surg. Published online December 21, 2016. doi:10.1001/jamasurg.2016.4750

The rising rate of contralateral prophylactic mastectomy (CPM) performed in the United States is a source of increasing concern for breast oncologists. Several studies using a variety of methodologic approaches have now definitively demonstrated negligible to no overall survival benefit associated with CPM even among women with a family history of breast cancer or a genetic mutation that confers an increased risk of breast cancer.13 In addition, studies that have demonstrated improved breast cancer–specific or overall mortality cite selection bias as the reason for this perceived benefit; that is, healthier and often more advantaged patients who are more likely to live longer after a diagnosis of breast cancer are also more likely to choose CPM than are less-advantaged women with more comorbidities.46

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