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Invited Commentary
March 2017

Contralateral Prophylactic Mastectomy: Aligning Patient Preferences and Provider Recommendations

Author Affiliations
  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina
JAMA Surg. 2017;152(3):282-283. 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.1-3 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.4-6