Contralateral prophylactic mastectomy : Aligning patient preferences and provider recommendations
Menée aux Etats-Unis à partir d'une enquête auprès de 2 578 patientes atteintes d'un cancer unilatéral du sein de stade 0 à II diagnostiqué entre 2013 et 2014 (âge moyen : 61,8 ans), cette étude analyse leurs connaissances sur la mastectomie controlatérale prophylactique, leur décision d'y avoir recours ou non ainsi que l'influence des recommandations des médecins sur cette décision
The rising rate of contralateral prophylactic mastectomy (CPM) performed in the United States is a source of increasing concern for breast oncologists. Several studies using a variety of methodologic approaches have now definitively demonstrated negligible to no overall survival benefit associated with CPM even among women with a family history of breast cancer or a genetic mutation that confers an increased risk of breast cancer. In addition, studies that have demonstrated improved breast cancer–specific or overall mortality cite selection bias as the reason for this perceived benefit; that is, healthier and often more advantaged patients who are more likely to live longer after a diagnosis of breast cancer are also more likely to choose CPM than are less-advantaged women with more comorbidities.
JAMA Surgery , commentaire, 2015