Selected high-risk women without
breast cancer choose to undergo bilateral
prophylactic mastectomy (BPM) to reduce their risk of developing the disease. Several studies have reported that BPM significantly reduces, but does not eliminate,
breast cancer risk. Few studies have reported rates or trends of BPM use. Patients with
unilateral breast cancer are at increased risk for developing
cancer in the normal contralateral breast. Some
breast cancer patients choose contralateral
prophylactic mastectomy (CPM) to prevent
cancer in the contralateral breast. The risk of contralateral
breast cancer is significantly reduced after CPM. Recent studies reported that CPM rates have markedly increased in recent years in the United States. Alternatives to CPM include surveillance with clinical breast examination, mammography, and, potentially, breast MRI. Endocrine
therapy with
tamoxifen or
aromatase inhibitors significantly reduces the risk of contralateral
breast cancer and may be more acceptable than CPM for some patients.