HealthDay News — According to a study published in JAMA Surgery, there was an increase in the proportion of women, with early-stage unilateral breast cancer treated with surgery, undergoing contralateral prophylactic mastectomy (CPM) from 2004 to 2012 — with considerable variation across states.

Rebecca Nash, MPH, from the Rollins School of Public Health at Emory University in Atlanta, and colleagues conducted a retrospective cohort study of 1.2 million women aged 20 years or older diagnosed with invasive unilateral early-stage breast cancer and treated with surgery. The researchers found that the proportion of the 1,224,947 women who underwent CPM nationally increased from 3.6 to 10.4% for those aged 45 years and older, and from 10.5 to 33.3% for those aged 20 to 44 years, between 2004 and 2012.

The increase was seen in all states, with variation in the magnitude across states. From 2004-2006 to 2010-2012 there was an increase in the proportion of women aged 20 to 44 years who underwent CPM from 14.9 to 24.8% in New Jersey, compared with an increase from 9.8 to 32.2% in Virginia.

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CPM proportions were over 42% in the states of Nebraska, Missouri, Colorado, Iowa, and South Dakota from 2010 to 2012 among women aged 20 to 44 years.

“Future studies should examine the reasons for the geographic variation and increasing trend in the use of CPMs,” the authors write.


Nash R, et al. “State Variation in the Receipt of a Contralateral Prophylactic Mastectomy Among Women Who Received a Diagnosis of Invasive Unilateral Early-Stage Breast Cancer in the United States, 2004-2012.” JAMA Surg. 2017. doi:10.1001/jamasurg.2017.0115 [Epub ahead of print]

Newman LA. “Do Patterns of Breast Cancer Surgical Care Reflect National Voting Records?” JAMA Surg. 2017. doi:10.1001/jamasurg.2017.0116 [Epub ahead of print]

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