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Annals of Surgical Oncology
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13-11-2024 | Breast Cancer | Breast Oncology

Society of Surgical Oncology Breast Disease Site Working Group Statement on Bilateral Risk-Reducing Mastectomy: Indications, Outcomes, and Risks

Authors: Puneet Singh, MD, MS, Doreen M. Agnese, MD, Miral Amin, MD, Andrea V. Barrio, MD, Astrid Botty van den Bruele, MD, Erin E. Burke, MD, David N. Danforth Jr., MD, Frederick M. Dirbas, MD, Firas Eladoumikdachi, MD, Oluwadamilola M. Fayanju, MD, MA, MPHS, Olga Kantor, MD, MS, Shicha Kumar, MD, Marie Catherine Lee, MD, Cindy Matsen, MD, Toan T. Nguyen, MD, Tolga Ozmen, MD, Ko Un Park, MD, Jennifer K. Plichta, MD, MS, Chantal Reyna, MD, MHA, Shayna L. Showalter, MD, Toncred Styblo, MD, Nicholas Tranakas, MD, Anna Weiss, MD, Ashley Woodfin, MD, Christine Laronga, MD, Judy C. Boughey, MD

Published in: Annals of Surgical Oncology | Issue 2/2025

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Abstract

Bilateral risk-reducing mastectomy (BRRM) is the surgical removal of both breasts to reduce the risk of cancer. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, outcomes, and risks of BRRM to update the society’s 2017 statement. We held a virtual meeting to outline key topics and conducted a literature search using PubMed to identify relevant articles. After literature review, recommendations were made according to group consensus. Individuals with a high lifetime risk of breast cancer due to pathogenic variants in high penetrance breast cancer–predisposition genes, early chest or breast radiation exposure, or a compelling family history should be counseled on the option of BRRM. However, BRRM is not recommended for most patients with high-risk lesions and may be contraindicated in patients who have other competing cancers and/or a high risk of surgical complications. BRRM effectively reduces the risk of breast cancer development, although the survival benefit is unclear. For patients with low-to-moderate breast cancer risk, alternative management strategies should be encouraged, including lifestyle modifications, high-risk screening, and risk-reducing medications. Discussions of BRRM should cover: (1) breast-cancer risk estimates; (2) the procedure’s degree of risk reduction and impact on survival; (3) surgical techniques, potential surgical complications and long-term sequelae; and (4) alternatives to surgery. Surgeons should encourage shared and informed decision making with patients who have an elevated lifetime risk of developing breast cancer.
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Metadata
Title
Society of Surgical Oncology Breast Disease Site Working Group Statement on Bilateral Risk-Reducing Mastectomy: Indications, Outcomes, and Risks
Authors
Puneet Singh, MD, MS
Doreen M. Agnese, MD
Miral Amin, MD
Andrea V. Barrio, MD
Astrid Botty van den Bruele, MD
Erin E. Burke, MD
David N. Danforth Jr., MD
Frederick M. Dirbas, MD
Firas Eladoumikdachi, MD
Oluwadamilola M. Fayanju, MD, MA, MPHS
Olga Kantor, MD, MS
Shicha Kumar, MD
Marie Catherine Lee, MD
Cindy Matsen, MD
Toan T. Nguyen, MD
Tolga Ozmen, MD
Ko Un Park, MD
Jennifer K. Plichta, MD, MS
Chantal Reyna, MD, MHA
Shayna L. Showalter, MD
Toncred Styblo, MD
Nicholas Tranakas, MD
Anna Weiss, MD
Ashley Woodfin, MD
Christine Laronga, MD
Judy C. Boughey, MD
Publication date
13-11-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2025
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-16484-2

Other articles of this Issue 2/2025

Circulating Micro-RNA as a Predictive Biomarker for Radiation Response in Pancreas Cancer

Periarterial Divestment and Triangle Clearance in Pancreatic Cancer: A Video Vignette

Hemodynamic Assessment Using SPY Laser Fluorescence Imaging During Pancreatoduodenectomy with Common Hepatic Artery Resection

ASO Visual Abstract: Reflections from the Annals of Surgical Oncology Social Media Committee: The Impact of Promoting Surgical Science Online

  • ASO Visual Abstract

ASO Author Reflections: Evolving Paradigms in the Management of Peritoneal Metastases Recurrences: Repeat Cytoreductive Surgery with HIPEC or Not—Insights from French Expert Centers

Robotic Total Anatomical Left Hepatectomy with En Bloc Caudate Resection and Systematic Portal Lymphadenectomy for Intrahepatic Cholangiocarcinoma

  • Gastrointestinal Oncology
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