Wisconsin Collaborative for Quality Healthcare

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Contralateral Prophylactic Mastectomy

The American Society of Breast Surgeon's Choosing Wisely® list, the National Comprehensive Cancer Network and the Society of Surgical Oncology indicate that there are no proven survival benefits to performing a contralateral prophylactic mastectomy (removal of an unaffected breast in a woman with breast cancer). Despite the lack of survival benefit, this procedure may be considered appropriate in cases where there is high risk of cancer occurring in the unaffected breast and/or radiographic surveillance of the unaffected breast would be difficult. Such factors may include genetic predisposition to breast cancer (such as BRCA1 or BRCA2), strong family history of breast cancer, high-risk histology (atypical hyperplasia or lobular carcinoma in situ), or prior radiation treatment to the chest.

The results below represent the percentage of women with newly diagnosed breast cancer between 7/1/2014 to 12/31/2014 who received a contralateral prophylactic mastectomy. These results are consistently calculated based on strict inclusion and measurement criteria applied to each institution's billing data. To account for possible genetic risk factors, we excluded from these calculations patients who had a documented family history of breast cancer, had undergone genetic counseling or testing (regardless of test result) or had a known genetic predisposition to breast cancer.

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Note: Results presented here are part of a federal grant from the National Cancer Institute (NCI) awarded to investigators at the Medical College of Wisconsin. The organizations participating in this project agreed to do so on a voluntary basis, and represent a majority of the WCHQ membership eligible for the study.