Patient experience with breast reconstruction process following bilateral mastectomy in BRCA mutation carriers

Breast cancer susceptibility gene (BRCA) mutation carriers have an increased risk of breast cancer. Mitigation of this risk can be achieved via surveillance or prophylactic mastectomy with or without breast reconstruction. Those that choose surgery expect to reduce their chance of developing cancer. The purpose of this study was to determine the incidence of patients developing breast cancer prior to surgery and to identify modifiable contributing factors within the patient journey. This is a historical cohort study of all BRCA mutation carriers identified through the British Columbia Cancer Hereditary Cancer Program between 2000 and 2012. Patients were divided into two groups: surveillance (S) and prophylactic mastectomy with immediate breast reconstruction (PM/IBR). The incidence of cancer, time to PM/IBR and patient journeys were analyzed. A total of 333 women were identified. The time to surgery from mutation disclosure was a median of 31 (5.3, 75.7) months. During this period, 6% of patients developed breast cancer compared with a 14% incidence of breast cancer in patients choosing surveillance. The majority of time to surgery was attributed to the period between mutation disclosure and the decision to proceed with surgery. Strategies to facilitate decision-making as well as wait list prioritization and dedicated operative time should be targeted to this population to decrease the number of women developing an interval cancer prior to surgery.

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How to manage BRCA mutation carriers?

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2019-0065 ◽

2020 ◽

Vol 41 (3) ◽

Author(s):

Laura Sabiani ◽

Julien Barrou ◽

Jérome Mathis ◽

Francois Eisinger ◽

Marie Bannier ◽

...

Keyword(s):

Brca Mutation ◽

Brca1 Mutation ◽

Brca2 Mutation ◽

Immediate Breast Reconstruction ◽

Bilateral Mastectomy ◽

Brca1 And Brca2 ◽

Mutation Carriers ◽

Brca Mutation Carriers ◽

The Impact ◽

Risk Reducing

AbstractInherited mutations in BRCA1 and BRCA2 genes increase the risk of development of cancer in organs especially in breast and ovary. Prevention and screening in BRCA mutation carriers are of high importance. Prophylactic surgeries are possible but are still insufficiently performed because they require surgical procedures in healthy patients. Guidelines for the management of BRCA mutations carriers must absolutely be part of the standard practice of all those involved in the management of these patients to increase the impact of the implementation of these preventive measures. There is no screening recommended for ovarian cancer. A risk-reducing bilateral salpingo-oophorectomy should be performed from age 35 to 40 years for BRCA1 mutation carriers and 40 to 45 years for BRCA2 mutation carriers. A screening for breast cancer should be performed annually from 30 years old by breast MRI and mammography. A risk-reducing bilateral mastectomy is recommended with nipple sparing mastectomy and immediate breast reconstruction from 30 years and before 40 years. A multidisciplinary care must be implemented for these patients with an important psychological support.

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Faculty of 1000 evaluation for The poly(ADP-ribose) polymerase inhibitor niraparib (MK4827) in BRCA mutation carriers and patients with sporadic cancer: a phase 1 dose-escalation trial.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.718052087.793484800 ◽

2013 ◽

Author(s):

Steve Plaxe ◽

Kristy Ward

Keyword(s):

Dose Escalation ◽

Brca Mutation ◽

Phase 1 ◽

Sporadic Cancer ◽

Mutation Carriers ◽

Brca Mutation Carriers ◽

Polymerase Inhibitor

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BRCA mutation carriers’ perceptions on postmenopausal hormone therapy (HT): An Italian study

Psycho-Oncology ◽

10.1002/pon.5714 ◽

2021 ◽

Author(s):

Giovanni Grandi ◽

Valentina Boggio Sola ◽

Laura Cortesi ◽

Angela Toss ◽

Giulia Andrea Giuliani ◽

...

Keyword(s):

Hormone Therapy ◽

Brca Mutation ◽

Postmenopausal Hormone Therapy ◽

Italian Study ◽

Postmenopausal Hormone ◽

Mutation Carriers ◽

Brca Mutation Carriers

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Determinants of serum adiponectin levels: a cross-sectional study

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2020-0057 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Azar Sattarinezhad ◽

Akbar Rasekhi Kazerouni ◽

Gholamhossein Ranjbar Omrani ◽

Mesbah Shams

Keyword(s):

Ovarian Cancer ◽

Germ Line ◽

Brca Mutation ◽

Bilateral Mastectomy ◽

Ovarian Cancer Risk ◽

Breast And Ovarian Cancer ◽

Double Blind ◽

Cross Sectional ◽

Mutation Carriers

Abstract Objectives To review non-surgical prevention strategies in women with hereditary breast and ovarian cancer syndromes. Content Women with a gBRCA1 or 2 mutations face a high cumulative breast and ovarian cancer risk. While bilateral mastectomy (PBM) and bilateral salpingo-oophrectomy (PBSO) profoundly reduce the respective cancer risks, they are also associated with considerable side effects. There is therefore an urgent need for alternative and non-surgical risk reduction options. Tamoxifen and aromatase inhibitors have both been evaluated in secondary prevention, but their benefit in primary prevention is currently unknown in BRCA mutation carriers. In addition, their use is compromised by their side effect profile which makes them less appealing for a use in chemoprevention. Summary and outlook Denosumab is a well-tolerated osteoprotective drug, which has been demonstrated to have a potential preventive effect particularly in BRCA1-deficient models in vitro. The prospectively randomized double-blind BRCA-P trial is currently investigating the preventative effect of denosumab in healthy BRCA1 germ line mutation carriers.

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