Trends of contralateral prophylactic mastectomy at the time of ipsilateral breast tumor recurrence

DR. FAAIZA VAINCE (Darien, Illinois): So prophylactic mastectomy trends are a relevant topic for discussion in breast cancer management, as the decision to pursue prophylactic mastectomies have increased in the last two decades. How are we going to counsel the patients? I think first by the genetic counseling as we have found that 24% do carry a positive genetic mutation at the time of recurrence and they tested positive, so we have to let them know that contralateral prophylactic mastectomy would offer a risk reduction by 94%, but it doesn't add a survival benefit. [...]if they were adamant to have a contralateral prophylactic mastectomy, they have to know that as we stated in our manuscript, contralateral prophylactic mastectomy is risk reducing, but it's not risk free, because studies have shown that 6% of the women who opt for a contralateral prophylactic mastectomy regret the decision owing to the complications related to the reconstruction and the need for reoperation and for aesthetic outcomes.