Surgeons’ contralateral breast cancer knowledge gaps identified

By Shreeya Nanda, Senior medwireNews Reporter

A survey of US surgeons reveals the gaps in the respondents’ knowledge of contralateral breast cancer (CBC) risk.

The 592 survey respondents scored well on questions pertaining to the survival benefit of contralateral prophylactic mastectomy (CPM) and the overall 5- and 10-year risk of CBC, with a respective 91.2%, 87.3% and 90.0% giving the correct answer.

But the surgeons did not score as well when asked about the CBC risk for specific subgroups of patients. For instance, only 39.9% responded correctly to the question about the 10-year risk of CBC in a newly diagnosed, 40-year-old BRCA carrier as being 20–30% or 30–40%. And just 70.6% knew the correct answer for the 5-year risk in patients with invasive lobular carcinoma and no additional risks was <2–5%.

Overall 39.2% of respondents had a “low level” of knowledge, defined as giving no more than three correct answers to the five questions comprising the survey.

The study authors could not ascertain how the surgeons’ knowledge affected the treatment options they offered to patients, but they wonder whether the rise in CPM rate over the past decade is ultimately attributable to the surgeons themselves not being well informed.

“Decision aids or teaching materials that address CPM and its utility for a patient with newly diagnosed breast cancer are needed”, say Katharine Yao (NorthShore University HealthSystem, Evanston, Illinois, USA) and co-workers in JAMA Surgery.

They admit, however, that their study has limitations, such as the low response rate – only 24.3% of the 2436 active members of the American Society of Breast Surgeons responded to the survey invitation.

And they note that the survey “did not address other aspects of CPM such as operative complications, reconstruction risks, or CBC risk for patients with other risk factors. Therefore, our findings may not reflect overall knowledge about CPM.”

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