90 Contralateral Risk Reduction Mastectomy in Patients With Unilateral Breast Cancer: A Multinational and Multidisciplinary Survey—Physicians’ Perspective

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement42nd Annual Miami Breast Cancer Conference® - Abstracts
Volume 39
Issue 4
Pages: 58-59

90 Contralateral Risk Reduction Mastectomy in Patients With Unilateral Breast Cancer: A Multinational and Multidisciplinary Survey—Physicians’ Perspective

90 Contralateral Risk Reduction Mastectomy in Patients With Unilateral Breast Cancer: A Multinational and Multidisciplinary Survey—Physicians’ Perspective

Background/Significance

Contralateral risk reduction mastectomy (RRM) is considered for patients with unilateral breast cancer to reduce the risk of cancer developing in the opposite breast. This study aimed to evaluate various specialists’ current practices, perspectives, and attitudes regarding RRM.

Materials and Methods

A multinational and multidisciplinary survey was conducted among Senologic International Society members, focusing on their specialties, geographical distribution, experience, institutional affiliations, and specific practices related to RRM.

Results

A total of 298 participants completed the survey. The majority of respondents were surgeons (79.2%, n = 236), followed by radiologists (7%, n = 21), radiation oncologists (7%, n = 21), and medical oncologists (6.4%, n = 19). Most participants practiced in Europe (46%, n = 137) and Asia (37.2%, n = 111), with contributions from other regions including Africa and North and South America. The majority of respondents had over 20 years of experience (44.3%, n = 132) and worked in academic hospitals (57.4%, n = 171). The most common indications among these were BRCA1/2 positivity (92.92%, n = 276), strong family history (41.07%, n = 112), and previous high-risk lesions (24.57%, n = 73). Less common factors included cosmetic concerns (18.85%, n = 56), patient anxiety (14.14%, n = 42), and young age (11.44%, n = 34). MRI was the most frequently preferred tool (82.15%, n = 244) for evaluating the contralateral breast before RRM, followed by mammography (80.47%, n = 239) and ultrasound (68.35%, n = 203). Genetic testing was used by 64.30% (n = 191) of respondents, while PET scans were less commonly used (6.39%, n = 19). The majority of the respondents believed RRM is highly or mostly effective in preventing breast cancer (79.2%, n = 206). About half of the respondents (49.82%, n = 146) decision to RRM on a case-by-case basis, while 32.42% (n = 95) of them indicated that the stage of the disease was not a pivotal factor in RRM decisions. The primary challenges for the decision of RRM were patient expectations (24.58%, n = 73), psychological/sexual issues (20.88%, n = 62), and insurance coverage and costs (17.17%, n = 51), but also surgery/reconstruction complications were one of the major components of their decision making (46.19%, n = 137). Less than half of the respondents (42.3%, n = 126) indicated their practice mostly aligns with established guidelines. The survey identified the need for further research in areas such as long-term outcomes and quality of life (51.01%, n = 151), survival benefit (33.44%, n = 99), and patient selection criteria (31.08%, n = 92).

Conclusion

The survey highlights diverse practices and perspectives on RRM across different specialties and countries. The findings emphasize the need for standardized guidelines and further research to improve patient outcomes such as survival and quality of life, and address challenges associated with managing RRM.

Articles in this issue

39 Development and Validation of a Questionnaire to Assess Motivation and Satisfaction in Mastectomy Patients With or Without Reconstruction
39 Development and Validation of a Questionnaire to Assess Motivation and Satisfaction in Mastectomy Patients With or Without Reconstruction
40 Frequency of Documented IHC Score in Patients With HER2-Negative Breast Cancer in the US: An Observational Study Using Guardian Research Network Data
40 Frequency of Documented IHC Score in Patients With HER2-Negative Breast Cancer in the US: An Observational Study Using Guardian Research Network Data
41 Provider Preferences and Practices in Testing and Reporting HER2 Immunohistochemistry in Patients With Breast Cancer: A Survey and Interview Study Among US Pathologists and Oncologists
41 Provider Preferences and Practices in Testing and Reporting HER2 Immunohistochemistry in Patients With Breast Cancer: A Survey and Interview Study Among US Pathologists and Oncologists
42 Exploring the Treatment Gap in High-Risk HR+, HER2– Early Breast Cancer: Eligible Patients Not Receiving Abemaciclib in the US
42 Exploring the Treatment Gap in High-Risk HR+, HER2– Early Breast Cancer: Eligible Patients Not Receiving Abemaciclib in the US
TPS 43 ADELA: A Double-Blind, Placebo-Controlled, Randomized Phase 3 Trial of Elacestrant + Everolimus vs Elacestrant + Placebo in ER+/HER2– Advanced Breast Cancer Patients With ESR1-Mutated Tumors Progressing on Endocrine Therapy
TPS 43 ADELA: A Double-Blind, Placebo-Controlled, Randomized Phase 3 Trial of Elacestrant + Everolimus vs Elacestrant + Placebo in ER+/HER2– Advanced Breast Cancer Patients With ESR1-Mutated Tumors Progressing on Endocrine Therapy
45 A Phase 3 Randomized Study of Adjuvant Sacituzumab Tirumotecan Plus Pembrolizumab vs Treatment of Physician’s Choice in Patients With Triple-Negative Breast Cancer Who Received Neoadjuvant Therapy and Did Not Achieve a Pathological Complete Response at Surgery
45 A Phase 3 Randomized Study of Adjuvant Sacituzumab Tirumotecan Plus Pembrolizumab vs Treatment of Physician’s Choice in Patients With Triple-Negative Breast Cancer Who Received Neoadjuvant Therapy and Did Not Achieve a Pathological Complete Response at Surgery
46 Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy Followed by Adjuvant Pembrolizumab or Placebo for High-Risk, Early-Stage Triple-Negative Breast Cancer: Overall Survival and Subgroup Results From the Phase 3 KEYNOTE-522 Study
46 Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy Followed by Adjuvant Pembrolizumab or Placebo for High-Risk, Early-Stage Triple-Negative Breast Cancer: Overall Survival and Subgroup Results From the Phase 3 KEYNOTE-522 Study
48 Prevalence of “HER2 Ultra-Low” Among Advanced Breast Cancer Patients With Historical IHC0 Status
48 Prevalence of “HER2 Ultra-Low” Among Advanced Breast Cancer Patients With Historical IHC0 Status
49 Clinical Characteristics and Treatment Persistence in US Patients With HR+/HER2–, Node-Positive Early Breast Cancer Treated With Abemaciclib: Real-World Study From First Year After Approval
49 Clinical Characteristics and Treatment Persistence in US Patients With HR+/HER2–, Node-Positive Early Breast Cancer Treated With Abemaciclib: Real-World Study From First Year After Approval
52 Correlation and Prediction of Complete Pathologic Response Rates and Ki-67 in Patients Receiving Neoadjuvant Immunotherapy for Triple-Negative Breast Cancer
52 Correlation and Prediction of Complete Pathologic Response Rates and Ki-67 in Patients Receiving Neoadjuvant Immunotherapy for Triple-Negative Breast Cancer
53 Comparison of Surgical Complications With Direct-to-Implant vs Tissue Expander Reconstruction After Wise Pattern Skin-Sparing Mastectomy
53 Comparison of Surgical Complications With Direct-to-Implant vs Tissue Expander Reconstruction After Wise Pattern Skin-Sparing Mastectomy
54 The Treatment of Breast Cancer With Percutaneous Thermal Ablation: Results of the THERMAC Trial
54 The Treatment of Breast Cancer With Percutaneous Thermal Ablation: Results of the THERMAC Trial
55 Do Genetic Counseling and Testing Affect Rates of Contralateral Prophylactic Mastectomy in Patients Without Clinically Actionable Mutations?
55 Do Genetic Counseling and Testing Affect Rates of Contralateral Prophylactic Mastectomy in Patients Without Clinically Actionable Mutations?
56 Paternal vs Maternal Inheritance of a BRCA Mutation: Is There a Difference in Presentation and Stage of Breast Cancer at Diagnosis?
56 Paternal vs Maternal Inheritance of a BRCA Mutation: Is There a Difference in Presentation and Stage of Breast Cancer at Diagnosis?
57 Tumor Morphology Concordance in Multifocal/Multicentric Triple- Negative and HER2+ Breast Cancers
57 Tumor Morphology Concordance in Multifocal/Multicentric Triple- Negative and HER2+ Breast Cancers
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