San Antonio Breast Cancer Symposium, 32nd, San Antonio, USA. Dec 2009.

Now in its 32nd year the annual San Antonio Breast Cancer Symposium is the premier scientific symposium in the world for breast surgical, radiation and medical oncologists, breast cancer researchers, and associated healthcare professionals. San Antonio has always been known as the most important clinical breast cancer meeting, is one of the world’s largest medical conferences and is arguably the best cancer research meeting in the world. Jane O’Brien joined more than 9000 other physicians, scientists and health professionals at the Henry B. Gonzales Convention Centre in San Antonio, Texas, USA from Dec. 9-13, 2009. The 2009 San Antonio Breast Cancer Symposium featured cutting-edge basic, translational and clinical research on breast cancer.

Rates of surgical removal of both breasts as a preventive measure in women diagnosed with cancer in only one breast have more than doubled in the United States within recent years. The annual incidence of contralateral breast cancer is about 0.5 percent to 0.75 percent and does not change with time. Some patients with cancer in a single breast (unilateral breast cancer) choose to have the other (contralateral) breast removed to prevent cancer in the opposite breast. The procedure is called a contralateral prophylactic mastectomy (CPM).

As breast cancer patients undergoing prophylactic contralateral mastectomy are generally not at high risk for contralateral breast cancer, they may be influenced by anxiety or imaging studies that may not have clinical relevance according to a study presented at the San Antonio Breast Cancer Symposium by researchers from Memorial Sloan-Kettering Cancer Center in New York City. From January 1997 to December 2005, CPM rates increased from 7% to 24% of women who underwent mastectomy at their institution.

Women who opted for prophylactic contralateral mastectomy were younger than those who did not undergo the added surgery and more likely to be white. Equally significant was that women choosing contralateral prophylactic mastectomy were more likely to have a family history of breast cancer, although just 13% of those who underwent prophylactic surgery were considered “high risk” such as because they were BRCA gene carriers. Clinical management factors strongly associated with prophylactic surgery included MRI at diagnosis and an additional biopsy in the contralateral breast because of MRI results. Breast conservation surgery had been initially attempted in more women in the prophylactic mastectomy group (28%, compared with 16%). The same women were more likely to undergo breast reconstruction, 87% vs. 51%, suggesting that some women may have chosen the added surgery in order to achieve cosmetic symmetry.