{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:23:17Z","timestamp":1787304197171,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Contralateral prophylactic mastectomy (CPM) is increasingly performed despite negative preoperative imaging. We evaluated the prevalence and MRI detectability of occult pathology in the contralateral breast. Methods: In 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\u2013Hochberg correction. Results: Occult 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\u20132), 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. Conclusions: After 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.<\/jats:p>","DOI":"10.3390\/cancers18162710","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:14:01Z","timestamp":1787300041000},"page":"2710","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Occult Pathology in the Contralateral Prophylactic Mastectomy Specimen Despite a Negative Contralateral MRI: A Single-Center Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8418-0234","authenticated-orcid":false,"given":"Osman Cem","family":"Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Breast Surgery, Private Clinic of Dr. Osman Cem Y\u0131lmaz, \u0130stanbul 34740, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2341-3572","authenticated-orcid":false,"given":"Adnan","family":"G\u00fcndo\u011fdu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sancaktepe \u015eehit Prof. Dr. \u0130lhan Varank Training and Research Hospital, \u0130stanbul 34785, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1108-8752","authenticated-orcid":false,"given":"Merve","family":"Akta\u015f","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Sakarya University Training and Research Hospital, Sakarya 54100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8700-3447","authenticated-orcid":false,"given":"K\u00fcbra","family":"Ertekin","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-300X","authenticated-orcid":false,"given":"Merve","family":"Toko\u00e7in","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ba\u011fc\u0131lar Training and Research Hospital, \u0130stanbul 34200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8861-5223","authenticated-orcid":false,"given":"Damiano","family":"Gentile","sequence":"additional","affiliation":[{"name":"Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5252-479X","authenticated-orcid":false,"given":"Ceyda","family":"S\u00f6nmez Wetherilt","sequence":"additional","affiliation":[{"name":"Department of Medical Pathology, Cerrahpa\u015fa Faculty of Medicine, \u0130stanbul University-Cerrahpa\u015fa, \u0130stanbul 34098, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6692-0828","authenticated-orcid":false,"given":"Levent","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiologica Imaging and Diagnostic Center, \u0130stanbul 34846, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","unstructured":"Steadman, J.A., Hoskin, T.L., Klassen, C., Boughey, J.C., Degnim, A.C., Piltin, M.A., Mrdutt, M.M., Johnson, J.E., and Hieken, T.J. 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