AIM: Women with a proven BRCA1 or BRCA2 germ-line mutation or with a 50% risk of carrying the mutation, have an increased risk of breast cancer. Regular surveillance, chemoprevention or prophylactic mastectomy (PM) are options to detect breast cancer at an early stage or to reduce the risk. We describe the management of women who have opted for PM, the postoperative complications of PM, especially in combination with immediate breast reconstruction (IBR), and the oncological follow-up. METHODS: The medical records of all women who underwent a PM from December 1993 to December 1999 have been reviewed with respect to management, patient characteristics, complications and oncological follow-up. RESULTS: During the study period 112 women with a median age of 38.8 years opted for a PM: 76 were germline mutation carriers. After PM, 79 women without breast or ovarian cancer in their medical history, were free of disease after 2.5 years (median). Before PM, 29 women had been treated for breast cancer, 3.9 years (median) previously; 5 of these women had developed metastatic disease by the last consultation. Before PM, 2 patients had been treated for DCIS and 2 patients for ovarian cancer. Four DCIS were found; none of these women had evidence of disease 4.0 years (median) after PM. In 59 women laparoscopic prophylactic bilateral oophorectomy (PBO) was performed; 36 simultaneously with PM and 23 separately. A total of 103 women (92%) opted for IBR. After PM, the complication rate for IBR was 21%: 11% within 6 weeks and 10% at long-term follow-up (median 3.5) after PM, including the removal of 10 prostheses. CONCLUSIONS: Women with an increased risk of breast cancer due to a genetic predisposition should be adequately informed about the different treatment options in the setting of a multidisciplinary approach. PM can simultaneously be combined with PBO and IBR. IBR can facilitate the decision to undergo a PM. PM followed by IBR has an acceptable complication rate.
AIM: Women with a proven BRCA1 or BRCA2 germ-line mutation or with a 50% risk of carrying the mutation, have an increased risk of breast cancer. Regular surveillance, chemoprevention or prophylactic mastectomy (PM) are options to detect breast cancer at an early stage or to reduce the risk. We describe the management of women who have opted for PM, the postoperative complications of PM, especially in combination with immediate breast reconstruction (IBR), and the oncological follow-up. METHODS: The medical records of all women who underwent a PM from December 1993 to December 1999 have been reviewed with respect to management, patient characteristics, complications and oncological follow-up. RESULTS: During the study period 112 women with a median age of 38.8 years opted for a PM: 76 were germline mutation carriers. After PM, 79 women without breast or ovarian cancer in their medical history, were free of disease after 2.5 years (median). Before PM, 29 women had been treated for breast cancer, 3.9 years (median) previously; 5 of these women had developed metastatic disease by the last consultation. Before PM, 2 patients had been treated for DCIS and 2 patients for ovarian cancer. Four DCIS were found; none of these women had evidence of disease 4.0 years (median) after PM. In 59 women laparoscopic prophylactic bilateral oophorectomy (PBO) was performed; 36 simultaneously with PM and 23 separately. A total of 103 women (92%) opted for IBR. After PM, the complication rate for IBR was 21%: 11% within 6 weeks and 10% at long-term follow-up (median 3.5) after PM, including the removal of 10 prostheses. CONCLUSIONS:Women with an increased risk of breast cancer due to a genetic predisposition should be adequately informed about the different treatment options in the setting of a multidisciplinary approach. PM can simultaneously be combined with PBO and IBR. IBR can facilitate the decision to undergo a PM. PM followed by IBR has an acceptable complication rate.
Authors: Oluwadamilola Motunaryo Fayanju; Carolyn R T Stoll; Susan Fowler; Graham A Colditz; Julie A Margenthaler Journal: Ann Surg Date: 2014-12 Impact factor: 12.969
Authors: Olivia Quilichini; Julien Barrou; Marie Bannier; Sandrine Rua; Aurore Van Troy; Laura Sabiani; Eric Lambaudie; Monique Cohen; Gilles Houvenaeghel Journal: Ann Med Surg (Lond) Date: 2020-12-31
Authors: Bernadette A M Heemskerk-Gerritsen; Cecile T M Brekelmans; Marian B E Menke-Pluymers; Albert N van Geel; Madeleine M A Tilanus-Linthorst; Carina C M Bartels; Murly Tan; Hanne E J Meijers-Heijboer; Jan G M Klijn; Caroline Seynaeve Journal: Ann Surg Oncol Date: 2007-05-31 Impact factor: 5.344
Authors: Li Sun; Adam Brentnall; Shreeya Patel; Diana S M Buist; Erin J A Bowles; D Gareth R Evans; Diana Eccles; John Hopper; Shuai Li; Melissa Southey; Stephen Duffy; Jack Cuzick; Isabel Dos Santos Silva; Alec Miners; Zia Sadique; Li Yang; Rosa Legood; Ranjit Manchanda Journal: JAMA Oncol Date: 2019-10-03 Impact factor: 31.777
Authors: M C T Batenburg; M L Gregorowitsch; W Maarse; A Witkamp; D A Young-Afat; A Braakenburg; A Doeksen; T van Dalen; M Sier; E J P Schoenmaeckers; C H van Gils; H J G D van den Bongard; H M Verkooijen Journal: Breast Cancer Res Treat Date: 2019-10-24 Impact factor: 4.872