For Mrs TT, she was concerned about the increased risk of contralateral breast cancer in the future based on her significant family history as well as being diagnosed with breast cancer before turning 40 years old. She has opted for bilateral skin sparing mastectomies with immediate implant reconstruction. This part of the paper will discuss the pros and cons of contralateral prophylactic mastectomy (CPM) and contributing factors to increased rate of prophylactic contralateral mastectomy.
Ductal carcinoma in situ (DCIS) is a pre-invasive breast cancer, where proliferations of malignant ductal epithelial cells remain confined within intact breast ducts.1 It is a precursor lesion that has the potential to transform into an invasive cancer over …show more content…
The wound complication rate was significantly higher in the BM group (5.8%).3 The unadjusted OR was 2.1 with 95% CI 1.3-3.2, P value <0.01.3 In addition, pneumonia, urinary tract infections and sepsis were significantly higher in the bilateral group than in the unilateral group.3 As compared to many others studies, NSQIP has probably underestimated the true rate of complications as it does not take into consideration outpatient management of complications, it is limited to 30 day follow-up and does not include some complications that are specific to breast reconstruction.8 Determining the rates of postoperative complications after breast surgery can be hard as published studies vary vastly in terms of length of follow up and severity of complications.8 However, it is definitely fair to state bilateral mastectomies could potentially bring more postoperative complications.8 On top of that, Mrs TT has an immediate breast reconstruction, which have been shown to be associated with high rates of post-operative complications, ranging from 43-64%.6,7 Barton et al. reported that almost two thirds of women undergoing bilateral prophylactic mastectomy had at least one complication after surgery, and fewer complications were observed in women who did not undergo
Ductal carcinoma in situ (DCIS) is a pre-invasive breast cancer, where proliferations of malignant ductal epithelial cells remain confined within intact breast ducts.1 It is a precursor lesion that has the potential to transform into an invasive cancer over …show more content…
The wound complication rate was significantly higher in the BM group (5.8%).3 The unadjusted OR was 2.1 with 95% CI 1.3-3.2, P value <0.01.3 In addition, pneumonia, urinary tract infections and sepsis were significantly higher in the bilateral group than in the unilateral group.3 As compared to many others studies, NSQIP has probably underestimated the true rate of complications as it does not take into consideration outpatient management of complications, it is limited to 30 day follow-up and does not include some complications that are specific to breast reconstruction.8 Determining the rates of postoperative complications after breast surgery can be hard as published studies vary vastly in terms of length of follow up and severity of complications.8 However, it is definitely fair to state bilateral mastectomies could potentially bring more postoperative complications.8 On top of that, Mrs TT has an immediate breast reconstruction, which have been shown to be associated with high rates of post-operative complications, ranging from 43-64%.6,7 Barton et al. reported that almost two thirds of women undergoing bilateral prophylactic mastectomy had at least one complication after surgery, and fewer complications were observed in women who did not undergo