TY  - CHAP
M1  - Book, Section
TI  - Chapter 11. Prophylactic Mastectomy
A1  - Boughey, Judy C.
A1  - Degnim, Amy C.
A2  - Kuerer, Henry M.
PY  - 2010
T2  - Kuerer's Breast Surgical Oncology
AB  - Patients  at  increased  risk  of  breast  cancer  have  a  range  of  treatment  options  available  to  decrease  their  risk  of  breast  cancer  development.  The  absolute  risk  reduction  by  any  of  these  strategies  is  dependent  on  the  individual  woman's  actual  risk  of  breast  cancer  development.  Statistical  models  for  risk  stratification,  as  well  as  the  availability  of  genetic  testing,  enable  women  and  their  physicians  to  evaluate  the  risk  of  breast  cancer.  A  number  of  risk-reducing  treatment  options  exist  for  these  women,  and  they  vary  in  efficacy.  Options  include  frequent  surveillance  with  clinical  examination  and  imaging,  chemoprevention,  prophylactic  salpingo-  oophorectomy  (PSO),  and  prophylactic  mastectomy  (PM).  The  individuals  most  likely  to  benefit  from  bilateral  PM  are  those  with  the  highest  risk—BRCA  carriers  and  those  with  a  strong  family  history  of  breast  cancer.  Women  with  a  personal  history  of  breast  cancer  are  also  at  higher  risk  for  a  second  primary  breast  cancer  in  the  contralateral  breast  and  may  choose  to  pursue  contralateral  prophylactic  mastectomy  (CPM)  to  decrease  this  risk  as  well  as  for  cosmetic  and  psychological  reasons.  As  a  preventive  measure  PM  remains  controversial.  There  are  no  randomized  controlled  trials  (and  likely  will  not  be  in  the  future)  to  substantiate  the  potential  benefit  or  harm  associated  with  PM.  Since  PM  is  an  irreversible  procedure,  providers  and  patients  must  understand  its  consequences,  benefits,  limitations,  and  available  alternatives.  This  chapter  discusses  which  patients  may  consider  prophylactic  surgery  and  summarizes  data  on  the  efficacy  of  PM  for  the  prevention  of  breast  cancer  and  its  effect  on  survival.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/24
UR  - accesssurgery.mhmedical.com/content.aspx?aid=6407519
ER  -