Abstract PS2-06-24: Global Prevalence of Prophylactic Mastectomy in Women: A Systematic Reviews and Meta-Analysis

Abstract IMPORTANCE The trend of prophylactic mastectomy is increasing globally, despite being an aggressive surgery with unclear effectiveness in cancer prevention. OBJECTIVE To estimate the global prevalence of prophylactic mastectomy in women to assess the predictive factors influence women’s decisions. DATA SOURCES PubMed, Embase, Web of Science, Scopus, Cochrane Library STUDY SELECTION Studies that (1) provided real-world data on the number of women who underwent prophylactic mastectomy in relation to the total population; (2) used the national or hospital database. DATA EXTRACTION AND SYNTHESIS The Restricted Maximum Likelihood (REML) estimator random-effects model with Freeman-Turkey double arcsine transformation was used for data analysis. Sensitivity analysis, meta-regression, and subgroup analysis were performed. MAIN OUTCOMES AND MEASURES The prevalence of prophylactic mastectomy was reported using data from the national databases and hospital sources. RESULTS Data from 10.7 million women across 23 countries were included. The overall prevalence of prophylactic mastectomy was 5.04% (95% CI, 5.03-5.06). Prevalence was highest in America (5.19%) and lowest in Asia (1.58%), highlighting differences in healthcare systems, cultural perceptions, and the significant influence of the “Angelina Jolie effect” in Western countries. Substantial differences in the prevalence of prophylactic mastectomy were noted when stratified by 28 predictive factors. Across all regions, genetic testing, healthcare accessibility, insurance support, and psychosocial factors were associated with increased prevalence of prophylactic mastectomy. CONCLUSION AND RELEVANCE Our findings indicate that the global prevalence of prophylactic mastectomy continues to increase. The notably higher rates in America, compared to other countries, reflect disparities in healthcare systems and inconsistent clinical practices worldwide. Global efforts, including standardized guidelines, established genetic testing criteria, and uniform counseling, are key to providing women with reliable information and support for informed decision-making. Citation Format: H. Y. Phi, T. V. Binh, E. W. Loh, K. W. Tam. Global Prevalence of Prophylactic Mastectomy in Women: A Systematic Reviews and Meta-Analysis [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-06-24.