1. Contralateral Prophylactic Mastectomy (CPM) Offers Limited Gains to Life


    Researchers from the Perelman School of Medicine at the University of Pennsylvania have just announced the results of research showing contralateral prophylactic mastectomy (CPM) provides little benefit but it can have significant effects on women. CPM is a procedure that removes the unaffected breast in patients with cancer in only one breast. The study shows that the surgery may in fact reduce the quality adjusted life expectancy -a measure of life expectancy that takes into account quality of life- among women whose breast cancer is not hereditary. These findings are very important for most women since only 10% of breast cancers are caused by hereditary factors.

    The researchers studied the impact of CPM on life expectancy and quality-adjusted life expectancy in groups of women with newly diagnosed unilateral breast cancer and no known genetic predisposition to the disease. The results of this study showed in this patients an increase of 150 percent in this kind of surgery.  The modest gain  in life expentacy was only for younger women with early-stage cancers whose type is known to carry a favorable prognosis. Even in these patients, the risk of death from their primary breast cancer far exceeded the risk of death from a breast cancer that may later develop on the opposite side.

    The procedure is often offered to women as if it would reduce greatly the odds of not having cancer again but it can actually have many complications. In the news release the authors hope the findings will assist patients and physicians in making informed decisions about treatment strategies, based on a clear understanding of the actual benefits and risks involved in preventive mastectomies, and the potential for the surgery to have an adverse impact on women’s quality of life.

    “We suspect that many of the women who elect to undergo CPM are acting on the belief the surgery will substantially reduce their overall risk of dying of breast cancer,” said senior author Robert G. Prosnitz, MD, MPH, an assistant professor of Radiation Oncology in the Perelman School of Medicine at the University of Pennsylvania. “However, our study shows that a woman’s risk of death from her primary breast cancer far outweighs her risk of death from a potential breast cancer developing in the unaffected breast. Additionally, the modest increase in life expectancy resulting from CPM may ultimately be negated by a reduction in quality of life.”

    These findings were reported at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium


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