Tuttle Todd, Habermann Elizabeth, Abraham Anasooya, Emory Timothy, Virnig Beth
University of Minnesota, Department of Surgery, Division of Surgical Oncology, 420 Delaware St SE, Minneapolis, MN, USA.
Expert Rev Anticancer Ther. 2007 Aug;7(8):1117-22. doi: 10.1586/14737140.7.8.1117.
Patients with unilateral breast cancer are at increased risk of developing a second cancer in the contralateral breast. Some women choose contralateral prophylactic mastectomy (CPM) to prevent cancer in the contralateral breast. Several studies have demonstrated that CPM significantly decreases the occurrence of contralateral breast cancer. However, the effectiveness of CPM at reducing breast cancer mortality is not as clear. Moreover, CPM is not risk free and patients may need to undergo additional surgical procedures, especially if reconstruction is performed. Nevertheless, most patients are satisfied with their decision to undergo CPM. Alternatives to CPM include close surveillance with clinical breast examination, mammography and possibly breast magnetic resonance imaging. Endocrine therapy with tamoxifen or aromatase inhibitors significantly reduces the risk of contralateral breast cancer and may be more acceptable than CPM for some patients. The decision to undergo CPM is complex and many factors likely contribute to its use. Future prospective studies are critically needed to evaluate the decision-making processes leading to CPM.
单侧乳腺癌患者对侧乳房发生第二种癌症的风险增加。一些女性选择对侧预防性乳房切除术（CPM）以预防对侧乳腺癌。多项研究表明，CPM可显著降低对侧乳腺癌的发生率。然而，CPM在降低乳腺癌死亡率方面的有效性尚不清楚。此外，CPM并非没有风险，患者可能需要接受额外的手术，特别是如果进行重建手术。尽管如此，大多数患者对接受CPM的决定感到满意。CPM的替代方案包括通过临床乳房检查、乳房X光检查以及可能的乳房磁共振成像进行密切监测。他莫昔芬或芳香化酶抑制剂的内分泌治疗可显著降低对侧乳腺癌的风险，对某些患者而言可能比CPM更易接受。接受CPM的决定很复杂，许多因素可能促使其被采用。迫切需要未来的前瞻性研究来评估导致CPM的决策过程。
