Affiliations: [a] Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA | [b] Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
Correspondence:
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Corresponding author: Ronald S. Chamberlain, MD, MPA, FACS, Chairman and Surgeon-in-Chief, Department of Surgery, Saint Barnabas Medical Center, Professor of Surgery, University of Medicine and Dentistry of New Jersey (UMDNJ), 94 Old Short Hills Rd. Livingston. NJ 07039, USA. Tel.: +1 973 322 5195; Fax: +1 973 322 2471; E-mail: [email protected]
Abstract: Background:Recently, the number of prophylactic mastectomies (PM) in the United States has increased due to a better understanding of the genetic and biological behavior of breast cancer. Consensus guidelines regarding indications for PM are published; however, studies evaluating adherence to published guidelines are lacking. The present study analyzed the indications and possible decision-making process leading to PM among 579 patients who underwent mastectomy. Study Design:Data from 579 female patients who underwent mastectomies between 01/2005 and 12/2007 were retrospectively collected and analyzed. Results:PM was performed in 128 patients. Contralateral prophylactic mastectomy was performed in 103 patients (80.5%), and 21 (16.4%) underwent bilateral prophylactic mastectomy (four patients (3.12%) with bilateral pathology were excluded). with a mean age of 49 ± 9 years. The indications for PM, either alone or in combination, included strong family history, prior history of breast cancer, histological risk factors and a BRCA mutation. Conclusions:Strong family history was the most common indication for PM and adherence to published consensus guidelines regarding the indications for PM was 97.6%. Depression, anxiety and hypothyroidism were the most common co-morbidities observed and the effect these conditions may have on the decision-making process for PM requires further evaluation.
