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Open Access 01-12-2007 | Breast Oncology

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

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

Published in: Annals of Surgical Oncology | Issue 12/2007

Abstract

Background

BRCA1/2 mutation carriers and women from a hereditary breast(/ovarian) cancer family have a highly increased risk of developing breast cancer (BC). Prophylactic mastectomy (PM) results in the greatest BC risk reduction. Long-term data on the efficacy and sequels of PM are scarce.

Methods

From 358 high-risk women (including 236 BRCA1/2 carriers) undergoing PM between 1994 and 2004, relevant data on the occurrence of BC in relation to PM, complications in relation to breast reconstruction (BR), mutation status, age at PM and preoperative imaging examination results were extracted from the medical records, and analyzed separately for women without (unaffected, n = 177) and with a BC history (affected, n = 181).

Results

No primary BCs occurred after PM (median follow-up 4.5 years). In one previously unaffected woman, metastatic BC was detected almost 4 years after PM (primary BC not found). Median age at PM was younger in unaffected women (P < .001), affected women more frequently were 50% risk carriers (P < .001). Unexpected (pre)malignant changes at PM were found in 3% of the patients (in 5 affected, and 5 unaffected women, respectively). In 49.6% of the women opting for BR one or more complications were registered, totaling 215 complications, leading to 153 surgical interventions (71%). Complications were mainly related to cosmetic outcome (36%) and capsular formation (24%).

Conclusions

The risk of developing a primary BC after PM remains low after longer follow-up. Preoperative imaging and careful histological examination is warranted because of potential unexpected (pre)malignant findings. The high complication rate after breast reconstruction mainly concerns cosmetic issues.

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Title: Prophylactic Mastectomy in BRCA1/2 Mutation Carriers and Women at Risk of Hereditary Breast Cancer: Long-Term Experiences at the Rotterdam Family Cancer Clinic
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
Publication date: 01-12-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 12/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9449-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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