Bouchard-Fortier A, Baxter N N, Sutradhar R, Fernandes K, Camacho X, Graham P, Quan M L
Division of Surgical Oncology, University of Calgary, Calgary, AB.
Department of Surgery, University of Toronto, Toronto, ON.
Curr Oncol. 2018 Dec;25(6):e562-e568. doi: 10.3747/co.25.4169. Epub 2018 Dec 1.
Contralateral prophylactic mastectomy (cpm) has been increasingly common among women with unilateral invasive breast cancer (ibca) even though the data that support it are limited. Using a population-based cohort, the objectives of the present study were to describe factors predictive of cpm in young women (≤35 years) with ibca and to evaluate the impact of the procedure on mortality.
All women diagnosed during 1994-2003 and treated with cpm were identified from the Ontario Cancer Registry. Logistic regression was used to identify patient and tumour factors associated with the use of cpm. Multivariate analyses were used to assess the effect of cpm on recurrence and mortality.
Of 614 women identified, 81 underwent cpm (13.2%). On multivariable analysis, factors associated with cpm included negative lymph node status, negative estrogen receptor status, and initial breast-conserving surgery with re-excision. At follow-up, breast cancer-specific mortality was similar for women who did and did not undergo cpm.
Use of cpm in young women with ibca (compared with non-use) was not associated improved breast cancer-specific mortality. Factors found to be predictive of cpm were negative lymph node status, negative estrogen receptor status, and initial breast-conserving surgery followed by re-excision.
对侧预防性乳房切除术（cpm）在单侧浸润性乳腺癌（ibca）女性中越来越普遍，尽管支持该手术的数据有限。本研究基于人群队列，旨在描述年轻（≤35岁）ibca女性中cpm的预测因素，并评估该手术对死亡率的影响。
从安大略癌症登记处识别出1994年至2003年期间诊断并接受cpm治疗的所有女性。采用逻辑回归来识别与cpm使用相关的患者和肿瘤因素。多变量分析用于评估cpm对复发和死亡率的影响。
在识别出的614名女性中，81名接受了cpm（13.2%）。多变量分析显示，与cpm相关的因素包括阴性淋巴结状态、阴性雌激素受体状态以及初始保乳手术并再次切除。随访时，接受和未接受cpm的女性乳腺癌特异性死亡率相似。
年轻ibca女性使用cpm（与未使用相比）与改善乳腺癌特异性死亡率无关。发现的cpm预测因素为阴性淋巴结状态、阴性雌激素受体状态以及初始保乳手术并再次切除。
