ArticleCancers2026
Occult Pathology in the Contralateral Prophylactic Mastectomy Specimen Despite a Negative Contralateral MRI: A Single-Center Cohort Study.
Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
BACKGROUND/
objectivesContralateral prophylactic mastectomy (CPM) is increasingly performed despite negative preoperative imaging. We evaluated the prevalence and MRI detectability of occult pathology in the contralateral breast.
methodsIn this single-center retrospective cohort, 82 patients with unilateral invasive breast cancer underwent simultaneous CPM after preoperative contralateral MRI. Occult findings were classified as occult malignancy, atypical/high-risk lesions, or other lesions of uncertain malignant potential (B3 lesions); the primary outcome was clinically significant occult pathology (malignancy or an atypical/high-risk lesion). Proportions are reported with exact 95% confidence intervals and associations with exact odds ratios and Benjamini-Hochberg correction.
resultsOccult malignancy occurred in 1/82 (1.2%; a single DCIS), clinically significant occult pathology in 14/82 (17.1%) and any occult pathology in 21/82 (25.6%). Among 59 patients with a negative MRI (BI-RADS 1-2), clinically significant occult pathology occurred in 18.6% and atypical/high-risk lesions in 16.9% (whole cohort, 15.9%). The single occult malignancy arose in an MRI-negative breast. No factor remained significant after correction for multiple comparisons.
conclusionsAfter preoperative MRI, occult malignancy is rare, whereas atypical and high-risk lesions frequently remain occult; a negative contralateral MRI excluded neither. These findings support individualized, shared decision-making rather than the yield of occult pathology as the basis for CPM.
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