Bilateral risk‐reducing mastectomy in BRCA mutation carriers: A difficult decision‐making

2019 ◽  
Vol 25 (3) ◽  
pp. 564-565 ◽  
Author(s):  
Gianluca Franceschini ◽  
Riccardo Masetti
2010 ◽  
Vol 77 (4) ◽  
pp. 342-349 ◽  
Author(s):  
A-B Skytte ◽  
A-M Gerdes ◽  
MK Andersen ◽  
L Sunde ◽  
K Brøndum-Nielsen ◽  
...  

2017 ◽  
Vol 24 (11) ◽  
pp. 3116-3123 ◽  
Author(s):  
Charlotte Gamble ◽  
Laura J. Havrilesky ◽  
Evan R. Myers ◽  
Junzo P. Chino ◽  
Scott Hollenbeck ◽  
...  

Breast Care ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 253-259
Author(s):  
Robin Segerer ◽  
Clara Peschel ◽  
Ulrike Kämmerer ◽  
Sebastian Häussler ◽  
Achim Wöckel ◽  
...  

Background/Objectives: BRCA mutation carriers and women at high risk of breast/ovarian cancer are faced with the intricate question to opt for prophylactic surgeries and/or a periodic screening. The aim of this study was therefore to identify objective and emotional factors that have an impact on the decision-making process. Methods: Ninety-five women with BRCA mutations or women at increased breast/ovarian cancer lifetime risk were counseled at our outpatient department and either opted for prophylactic surgery or periodic screening. To identify the psychological factors that could have influenced the decision-making, a standardized questionnaire was applied. Additionally, clinical data were collected and were reviewed by a personal talk. Results: Seventy-one of the patients opted for an increased surveillance only, 21 for prophylactic surgeries. Positive predictors for prophylactic surgeries were sociodemographic characteristics such as parity and objective variables such as verified mutation status. Hierarchical regression analysis revealed that the need for safety in health issues has been the only significant psychological predictor of surgery beyond the objective factors. Fear of surgical procedures, menopausal symptoms after surgery, loss of attractiveness, or fear of interferences with sexual life did not significantly affect decision-making. Conclusion: Decision-making towards prophylactic surgeries is influenced by objective but also emotional factors. Knowing that fear and anxiety also have an important impact on decision-making, distinct counselling about the procedures, the subsequent risk reduction as well as the psychological effects of prophylactic surgeries are essential.


2019 ◽  
Vol 133 (1) ◽  
pp. 6-6
Author(s):  
Annelise Marie Wilhite ◽  
Makinna Caitlin Oestreich ◽  
Donna Coetzee ◽  
Mahmoud Khalifa ◽  
Britt Erickson

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13046-e13046
Author(s):  
Yong-Man Kim ◽  
Shin-Wha Lee ◽  
Young-jae Lee

e13046 Background: Most BRCA1/2 carriers do not undergo risk-reducing salpingo-oophorectomy (RRSO) by the recommended age of 40. Methods: We retrospectively reviewed breast cancer patients identified as BRCA mutation carriers who underwent RRSO at Asan Medical Center, Seoul, Korea, from 2013 to 2015. Both fallopian tubes of all cases were examined according to the SEE/FIM protocol and immunohistochemically (IHC) staining was performed when a precursor lesion was suspected. Results: RRSO was performed in 55 patients. The median age at RRSO was 44 years (32–73 years). Of the 36 patients with IHC staining, 7 showed p53 overexpression, 1 showed Ki-67 overexpression, 2 showed serous tubal intraepithelial carcinoma, 2 showed occult cancer, and 1 showed metastatic cancer of breast origin. All occult invasive cancer cases were tubal origin and detected in patients older than 40 years. The detection rate of premalignant lesions or cancer was 21.8% (12/55). Among patients who underwent RRSO under the age of 40, premalignant lesions were found only in BRCA 1 mutation carriers (40.0% vs 0%). In BRCA 2 mutation carriers, premalignant lesions were only detected in those older than 40 years of age, indicating the possible faster occurrence of premalignant lesions in BRCA1 mutation carriers. Conclusions: Many patients still tend to delay RRSO until after they are 40 years old. Our findings support the significance of RRSO before the age of 40 in germline BRCA mutation carriers, especially in BRCA 1 mutation carriers.


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