(see June 3, 2014 blog "ContralateralProphylactic Mastectomy: Deciding with Your Head or Your Heart?")
Now the American Society of Breast Surgeons (ASBS) has issued a position statement recommending against contralateral preventive mastectomy for women of average risk for breast cancer.
The ASBS is encouraging a greater focus on patient education to help women who face mastectomy to understand the risks and benefits of removing their remaining healthy breast. For most women who have cancer in one breast, the odds of a diagnosis in the opposite breast is 2 to 6% over the next 10 years. The organization’s statement recommends that physicians ensure their patients are engaged in decision making, and have all the information they need to make that decision.
The ASBS statement states that contralateral prophylactic mastectomy:
- should be considered for women at significant risk for contralateral breast cancer, including women with BRCA mutations, a strong family history of breast cancer, or a history of chest radiation before age 30
- may be considered for women with other genetic risk, or no identified genetic risk but a strong family history of breast cancer
- may be appropriate in for other women to limit contralateral breast surveillance, improve symmetry from breast reconstruction, manage risk aversion or manage extreme anxiety
- should be discouraged for women of average risk who have unilateral breast cancer or advanced index cancer, those at high risk for surgical complications, and women mutation who test negative for a known BRCA mutation in their family
Whatever you decide to do, take the time you need to learn about and understand your options, and the risks and benefits of keeping or removing your healthy breast.