Hereditary Breast Cancer: Prophylactic Mastectomy, Breast Conservation, and Rates of Cancer

2019 ◽  
pp. 33-42
Author(s):  
Siun M. Walsh ◽  
Mark E. Robson ◽  
Virgilio S. Sacchini
Keyword(s):  
Breast Cancer ◽  
Hereditary Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Breast Conservation

scholarly journals Breast Conservation and Hypofractionation in Women with Hereditary Breast Cancer

2019 ◽  
Vol 105 (1) ◽  
pp. E54-E55
Author(s):  
J. Ghobrial ◽  
J. Xiao ◽  
C. Oh ◽  
O.G. Maisonet ◽  
J. Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hereditary Breast Cancer ◽  
Breast Conservation

scholarly journals Prophylactic Mastectomy in BRCA1/2 Mutation Carriers and Women at Risk of Hereditary Breast Cancer: Long-Term Experiences at the Rotterdam Family Cancer Clinic

2007 ◽  
Vol 14 (12) ◽  
pp. 3335-3344 ◽  
Author(s):  
Bernadette A. M. Heemskerk-Gerritsen ◽  
Cecile T. M. Brekelmans ◽  
Marian B. E. Menke-Pluymers ◽  
Albert N. van Geel ◽  
Madeleine M. A. Tilanus-Linthorst ◽  
...  
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Hereditary Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Mutation Carriers ◽  
Cancer Clinic

Body image issues after bilateral prophylactic mastectomy with breast reconstruction in healthy women at risk for hereditary breast cancer

2012 ◽  
Vol 12 (3) ◽  
pp. 479-487 ◽  
Author(s):  
Jessica P. Gopie ◽  
Marc A. M. Mureau ◽  
Caroline Seynaeve ◽  
Moniek M. ter Kuile ◽  
Marian B. E. Menke-Pluymers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Body Image ◽  
Breast Reconstruction ◽  
Hereditary Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Healthy Women ◽  
Bilateral Prophylactic Mastectomy ◽  
Body Image Issues

Clinical Management Factors Contribute to the Decision for Contralateral Prophylactic Mastectomy

2011 ◽  
Vol 29 (16) ◽  
pp. 2158-2164 ◽  
Author(s):  
Tari A. King ◽  
Rita Sakr ◽  
Sujata Patil ◽  
Inga Gurevich ◽  
Michelle Stempel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Breast Conservation ◽  
Contralateral Prophylactic Mastectomy ◽  
Cancer Center ◽  
Unilateral Breast Cancer ◽  
Brca Mutations ◽  
Immediate Reconstruction ◽  
Magnetic Resonance Imaging Mri ◽  
Index Cancer

Purpose To determine whether increasing rates of contralateral prophylactic mastectomy (CPM) are due to recognition of risk factors for contralateral breast cancer (CBC) or treatment factors related to the index lesion. Methods From 1997 to 2005, 2,965 patients with stage 0 to III primary unilateral breast cancer underwent mastectomy at Memorial Sloan-Kettering Cancer Center. Patients who did and did not undergo CPM within 1 year of treatment for their index cancer were compared to identify independent predictors of CPM. Results The rate of CPM was 13.8% (n = 407), increasing from 6.7% in 1997 to 24.2% in 2005 (P < .0001). Patients with BRCA mutations or prior mantle radiation (n = 52) accounted for 13% of those having CPM. The rate of CPM by surgeon varied from 1% to 26%. Multivariate logistic regression adjusting for surgeon-identified white race (odds ratio [OR] = 3.3), immediate reconstruction (OR = 3.3), family history of breast cancer (OR = 2.9), magnetic resonance imaging (MRI) at diagnosis (OR = 2.8), age younger than 50 years (OR = 2.2), noninvasive histology (OR = 1.8), and prior attempt at breast conversation (OR = 1.7) to be independent predictors of CPM. Conclusion These data suggest that increasing use of CPM is not associated with increased recognition of patients at high risk for CBC. Treatment factors, such as immediate reconstruction, preoperative MRI, and unsuccessful attempts at breast conservation, are associated with increased rates of CPM. Efforts to optimize breast conservation, minimize unnecessary tests, and improve patient education about the low risk of CBC may help to curb this trend.

Predictors of Contralateral Prophylactic Mastectomy in Women With a BRCA1 or BRCA2 Mutation: The Hereditary Breast Cancer Clinical Study Group

2008 ◽  
Vol 26 (7) ◽  
pp. 1093-1097 ◽  
Author(s):  
Kelly A. Metcalfe ◽  
Jan Lubinski ◽  
Parviz Ghadirian ◽  
Henry Lynch ◽  
Charmaine Kim-Sing ◽  
...  
Keyword(s):  
Breast Cancer ◽  
North America ◽  
Hereditary Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Brca2 Mutation ◽  
Contralateral Prophylactic Mastectomy ◽  
Contralateral Breast ◽  
Prophylactic Contralateral Mastectomy ◽  
Preventive Surgery ◽  
Contralateral Mastectomy

Purpose To evaluate the rate of prophylactic contralateral mastectomy in an international cohort of women with hereditary breast cancer and to evaluate the predictors of uptake of preventive surgery. Patients and Methods Women with a BRCA1 or BRCA2 mutation who had been diagnosed with unilateral breast cancer were followed prospectively for a minimum of 1.5 years. Information was collected on prophylactic surgery, tamoxifen use, and the occurrence of contralateral breast cancer. Results Nine hundred twenty-seven women were included in the study; of these, 253 women (27.3%) underwent a contralateral prophylactic mastectomy after the initial diagnosis of breast cancer. There were large differences in uptake of contralateral prophylactic mastectomy by country, ranging from 0% in Norway to 49.3% in the United States. Among women from North America, those who had a prophylactic contralateral mastectomy were significantly younger at breast cancer diagnosis (mean age, 39 years) than were those without preventive surgery (mean age, 43 years). Women who initially underwent breast-conserving surgery were less likely to undergo contralateral prophylactic mastectomy than were women who underwent a mastectomy (12% v 40%; P < 10−4). Women who had elected for a prophylactic bilateral oophorectomy were more likely to have had their contralateral breast removed than those with intact ovaries (33% v 18%; P < 10−4). Conclusion Age, type of initial breast cancer surgery, and prophylactic oophorectomy are all predictive of prophylactic contralateral mastectomy in women with breast cancer and a BRCA mutation. The acceptance of contralateral preventive mastectomy was much higher in North America than in Europe.

Surgeon influence on receipt of contralateral prophylactic mastectomy for breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18145-e18145
Author(s):  
Steven J. Katz ◽  
Monica Morrow ◽  
Sarah T. Hawley ◽  
Reshma Jagsi
Keyword(s):  
Breast Cancer ◽  
Los Angeles ◽  
Prophylactic Mastectomy ◽  
Early Stage ◽  
Breast Conservation ◽  
Contralateral Prophylactic Mastectomy ◽  
Population Based ◽  
Average Risk ◽  
Practice Approach ◽  
Unilateral Disease

e18145 Background: Rates of contralateral prophylactic mastectomy (CPM) have markedly increased but virtually nothing is known about the influence of surgeons on variability of the procedure in the community. We quantified the influence of attending surgeon on rates of CPM and clinician attitudes that explained it. Methods: Population-based sample of 7810 patients newly diagnosed with curable breast cancer (BC) in Georgia and Los Angeles County treated in 2013-15 were surveyed (response rate 70%, n = 5018) and responses were linked to 488 attending surgeons through patient report. Surveys were sent to surgeons towards the end of the patient data collection period and 377 completed them (response 77%). We linked 3718 respondent patients with unilateral disease to 365 respondent surgeons. Two surgeon attitudes scales were developed based on a scenario of a patient with early stage BC at average risk of a 2nd primary cancer: 1) favors initial breast conservation and, 2) reluctance to perform CPM if patient asks. We did multilevel analyses using information from patient and surgeon reports merged to SEER data. Results: A model including patient clinical factors and surgeon id predicted CPM extremely well as it explained 37% of the variability in the likelihood of CPM. Patient factors explained 16% of the variability but the surgeon identifier alone explained even more (21%). The odds of a patient receiving CPM increased 3-fold (95% CI 1.9, 4.7) if she saw a surgeon with a practice approach one standard deviation above a surgeon with the average CPM rate (15%). One quarter (24%) of the surgeon influence was explained by attending attitudes about initial recommendations for surgery and responses to patient requests for CPM. The rate of CPM was 34% for surgeons who least favored initial breast conservation and were least reluctant to perform CPM. By contrast, the estimated rate was 5% for surgeons who most favored initial breast conservation and were most reluctant to perform CPM if asked. Conclusions: Attending surgeons exert strong influence on the likelihood of receipt of CPM for breast cancer. Variations in surgeon attitudes about recommendation for surgery and response to patients request for CPM explain a substantial amount of this influence.

scholarly journals Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy

2009 ◽  
Vol 7 (1) ◽  
Author(s):  
Murly BM Tan ◽  
Eveline MA Bleiker ◽  
Marian BE Menke-Pluymers ◽  
Arthur R Van Gool ◽  
Silvia van Dooren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hereditary Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Increased Risk
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