Preventive Mastectomy Rates Increase despite Lack of Survival Benefit

Posted by Brigham and Women's Hospital March 31, 2016

Patients and caregivers should weigh the expected benefits with the potential risks of .

Patients and caregivers should weigh the expected benefits with the potential risks of a contralateral (double) prophylactic mastectomy.

A recent Brigham and Women’s (BWH) study reveals that from 2002 to 2012, the number of women choosing to have both of their breasts removed as a strategy to prevent the recurrence of breast cancer – a procedure known as contralateral prophylactic mastectomy (CPM) – tripled in the U.S., but without a corresponding improvement in  survival. Researchers note that while CPM may have a survival benefit for patients that are at high risk of developing breast cancer, such as those with a genetic mutation, the majority of women undergoing CPM are at low risk for developing breast cancer in the unaffected breast.

“Our analysis highlights the sustained, sharp rise in popularity of CPM, while contributing to the mounting evidence that this more extensive surgery offers no significant survival benefit to women with a first diagnosis of breast cancer,” says senior author Dr. Mehra Golshan, Distinguished Chair in Surgical Oncology at BWH. “Patients and caregivers should weigh the expected benefits with the potential risks of CPM, including prolonged recovery time, increased risk of operative complications, cost, the possible need for repeat surgery, and effects on self image.”

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Imaging Technique May Reduce Need for Follow-Up Breast Cancer Surgery

Posted by Brigham and Women's Hospital October 2, 2014

The researchers' new breast imaging approach will be tested in the AMIGO suite.

Currently, up to 40 percent of patients undergoing breast-conserving surgery to treat cancer require re-operation because of a failure to remove all of the cancerous tissue during the initial operation. Brigham and Women’s Hospital (BWH) researchers, however, have successfully tested an innovative tissue imaging approach that accurately distinguishes cancerous breast tissue from normal breast tissue and precisely defines the margins between the two – an advance that could significantly decrease the need for follow-up surgery.

The tool the researchers used for their study is called desorption electrospray ionization (DESI) mass spectrometry imaging, a technology that allows physicians and researchers to promptly evaluate human tissue. It works by electrically charging (ionizing) molecules in a tissue sample through the application of a microscopic stream of solvent. The mass of these ionized molecules is then measured and their distribution within the tissue is mapped.

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Reducing Repeat Surgeries after Breast Cancer

Posted by Brigham and Women's Hospital January 30, 2013

Surgical oncologist Mehra Golshan, MD, (left) and members of the AMIGO team perform a practice run of a lumpectomy procedure on Nov. 15, 2012.

When Jane Davis was diagnosed with breast cancer in July 2012, she began learning as much as she could about the disease. Davis quickly discovered one of the most startling statistics about breast cancer — that up to 40 percent of women in the U.S. who undergo a lumpectomy to remove a tumor require a second surgery. That’s because surgeons often are unable to microscopically remove the entire tumor during the first surgery.

Dr. Mehra Golshan, Director of Breast Surgical Services at Dana-Farber/Brigham and Women’s Cancer Center, is trying to change that with his research using image-guided therapy, available through the Advanced Multimodality Image Guided Operating (AMIGO) suite at Brigham and Women’s Hospital, to perform more precise breast surgeries.

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