Evidence map›Paper›PMID 31750934›Full record

ArticleCancer2020

Magnitude of reduction in risk of second contralateral breast cancer with bilateral mastectomy in patients with breast cancer: Data from California, 1998 through 2015.

Allison W Kurian, Alison J Canchola, Cindy S Ma, Christina A Clarke, Scarlett L Gomez

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 23 citations in OpenAlex.

  1. Immigration and Social Factors, Tumor Stage, and Risk of Contralateral Breast Cancer in Asian American and Hispanic Women.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Allison W KurianDepartment of Medicine, Stanford University School of Medicine, Stanford, California.ORCID 0000-0002-6175-9470
Alison J CancholaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
Cindy S MaDepartment of Medicine, Stanford University School of Medicine, Stanford, California.
Christina A ClarkeDepartment of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
Scarlett L GomezDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.ORCID 0000-0002-5143-4867
Stanford University · USUniversity of California, San Francisco · USMenlo School · US

Funding

NCCDPHP CDC HHS NU58DP006344NCI NIH HHS HHSN261201800009CNCI NIH HHS HHSN261201800009INCI NIH HHS HHSN261201800010CNCI NIH HHS HHSN261201800010INCI NIH HHS HHSN261201800015CNCI NIH HHS HHSN261201800015INCI NIH HHS HHSN261201800032CNCI NIH HHS HHSN261201800032I
6 · The paper itself

Abstract

backgroundIncreasingly, patients with breast cancer undergo bilateral mastectomy (BLM). To the authors' knowledge, the magnitude of benefit is unknown.

methodsThe authors used data from the Surveillance, Epidemiology, and End Results (SEER) program regarding all women diagnosed with American Joint Committee on Cancer stage 0 to stage III unilateral breast cancer in California from 1998 through 2015 and treated with BLM versus breast-conserving therapy including surgery and radiotherapy (BCT) or unilateral mastectomy (ULM). The authors measured relative risks of second contralateral breast cancer (CBC) and breast cancer death using Fine and Gray multivariable regression modeling adjusted for the competing risk of death and death from another cause, respectively, and potential confounding factors. Absolute excess risk of CBC was measured as the observed minus expected number of breast cancers in the general population divided by 10,000 person-years at risk.

resultsAmong 245,418 patients with a median follow-up of 6.7 years, 7784 patients (3.2%) developed CBC. Relative risks were lower after BLM (hazard ratio [HR], 0.10; 95% CI, 0.07-0.14) and higher after ULM (HR, 1.07; 95% CI, 1.02-1.13) versus BCT. Absolute excess risks were higher after BCT and ULM (5.0 and 13.6 more cases, respectively) compared with BLM (28.6 fewer cases). BLM reduced risk more among older women (38.0 fewer cases for women aged ≥50 years vs 17.9 fewer cases among women aged <50 years) but provided similar risk reduction across categories of tumor grade and tumor hormone receptor status. Compared with BCT, the risk of breast cancer death was equivalent after BLM (HR, 1.03; 95% CI, 0.96-1.11) and higher after ULM (HR, 1.21; 95% CI, 1.17-1.25).

conclusionsBLM may reduce second breast cancer risk by 34 to 43 cases per 10,000 person-years compared with other surgical procedures, but is not associated with a lower risk of death. Second breast cancers are rare, and their reduction should be weighed against the harms associated with BLM.

Indexed as

AdultAgedBreast NeoplasmsCaliforniaFemaleFollow-Up StudiesHumansMastectomyMiddle AgedNeoplasm GradingNeoplasms, Second PrimaryNeoplasm StagingRisk FactorsSEER ProgramTime Factorsabsolute excess riskbilateral mastectomybreast cancercancer preventionsecond contralateral breast cancer

Identifiers

PMID31750934
PMCPMC7021576
OpenAlexW2990776348

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.