Contralateral Prophylactic Mastectomy (CPM)
Having surgery to remove a healthy breast:
What you need to know before you make a decision
Making a decision about CPM:
I have breast cancer
I have a family history of breast and/or ovarian cancer
I could meet with a genetic counsellor to discuss genetic testing
I have a gene mutation in BRCA1 or BRCA2
Yes
I should consider having a CPM
I have a gene mutation in BRCA1 or BRCA2
No
I do not need a CPM and should talk to my
surgeon about the risks of this procedure
Frequently asked questions about
Contralateral Prophylactic Mastectomy (CPM):
remove my healthy breast?
There are risks for every surgery. In every case, there is a balance between whether the risks of surgery outweigh the benefits of having surgery.
Cancer Risks
The removal of both breasts could mean it will take more time to get chemotherapy or radiation therapy
if there are complications with healing and recovery from the surgery.
In rare cases, cancer may still recur on the chest wall after mastectomy or after reconstruction.
Risks of Surgery
Removing two breasts instead of one breast is a large surgery that has twice the complications, including: bleeding, infection and wound-healing problems.
Patients who have both breasts removed are at higher risk for post-mastectomy pain syndrome, which can mean pain for many years. This may mean that you have to take pain medication permanently.
Risks of Breast Reconstruction Surgery
85% of women have some body image or pain issues after mastectomy and reconstruction. Reconstructed breasts have little-to-no feeling.
» If I have breast cancer in one breast, does it mean I will get it in the other breast?
No. The evidence tells us that women who are at
low or average risk for breast cancer have a 5%
chance of getting a new breast cancer over 10 years.
» Does breast cancer spread from one breast to the other?
No. Breast cancer does not spread from one breast
to the other. If it spreads, it usually goes to the lymph nodes in the armpit on the same side as the breast cancer. For example, a right breast cancer spreads
to the lymph nodes in the right armpit. It would not spread to the left breast.
» Will a contralateral prophylactic mastectomy (CPM) lower my risk of the breast cancer spreading to other parts of my body?
No. Having your healthy breast removed will not lower the chances of the original breast cancer spreading to other parts of your body.
The research tells us that many women believe having surgery to remove the healthy breast will improve their chances of living longer, or will stop the spread of cancer to the other breast. There is no evidence to support this.
» How do I know what my risk of getting breast cancer in the healthy breast is?
Women are at high risk of a new cancer in their other breast if they are carriers of a BRCA1 or BRCA2 gene mutation.
If you have a strong family history of breast and/or ovarian cancer, you can speak with a genetic counsellor about your risk of having a BRCA1 or BRCA2 gene mutation.
IMPORTANT: If you either do not have, or are at low risk of having, a BRCA1 or BRCA2 gene mutation, your chance of getting breast cancer in the healthy breast is about 5% over the next 10 years. That means there is a 95% chance that you will not get a second breast cancer during this time.» Will a contralateral prophylactic mastectomy (CPM) be better for breast reconstruction surgery?
Many women think that having both the breast with cancer and the healthy breast removed will improve matching of breast size and shape.
New ways of doing surgery to reconstruct the breast can make the breast that was removed look much the same as your healthy breast.
» I have had a MRI and it shows some areas of concern in the healthy breast. Should I get a contralateral prophylactic mastectomy (CPM)?
You may have an appointment where the breast is examined by your health care provider, as well as another MRI, which will tell us whether there is a change in the area of concern.
