Influence of contralateral prophylactic mastectomy on textbook outcome attainment at time of mastectomy

Introduction: The objective of this study was to determine the incidence of textbook oncologic outcome (TOO) and its impact on overall survival (OS) among patients with invasive ductal carcinoma (IDC) following modified radical mastectomy (MRM) versus MRM with contralateral prophylactic mastectomy (MRM + CPM). Methods: The 2004-2017 National Cancer Database was queried for patients with IDC who underwent MRM and MRM + CPM. TOO was defined as: resection with negative margins, adequate lymphadenectomy, length of stay <= 50th percentile, and no 30-day readmission or mortality. Results: 87,573 patients were identified, of which 14.3% underwent MRM + CPM. Logistic regression models revealed that MRM + CPM is independently associated with a reduced likelihood of achieving TOO (AOR = 0.71; P < 0.001). MRM patients who achieved TOO had a higher median OS compared to those who did not (164.6 vs.142.2 months, P < 0.001). Conclusions: MRM + CPM is associated with a lower incidence of TOO attainment compared to MRM.