Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2011

01-03-2011 | Breast Oncology

Breast Cancer Surgery Trend Changes Since the Introduction of BRCA1/2 Mutation Screening: A Retrospective Cohort Analysis of 158 Mutation Carriers Treated at a Single Institution

Authors: Angela Mislowsky, MD, Susan Domchek, MD, Cecilia Stroede, MD, Meredith R. Bergey, MS, Seema S. Sonnad, PhD, Liza Wu, MD, Julia Tchou, MD, PhD

Published in: Annals of Surgical Oncology | Issue 3/2011

Login to get access

Abstract

Background

Bilateral mastectomy in women diagnosed with unilateral breast cancer is on the rise in the USA. One contributing factor is increased awareness of contralateral breast cancer risk. Positive testing for deleterious mutation in BRCA1/2 is a concrete measure of this contributing factor. We hypothesize that breast cancer surgery trend change is temporally associated with the introduction of BRCA1/2 genetic testing around 1996.

Methods

Our study cohort included 158 BRCA1 or BRCA2 mutation carriers diagnosed with unilateral breast cancer between 1963 and 2009. Mutation carriers with ovarian cancer or bilateral breast cancer were excluded. Breast surgery and breast reconstruction surgery trends were analyzed according to year of breast cancer diagnosis or when bilateral mastectomy was performed, respectively.

Results

Surgery trends changed significantly over time. We observed a significant drop in the rate of unilateral mastectomy (P < 0.001) after the period 1996–2000, and the rate of bilateral mastectomy appears to be on the rise, up to 30.3% between 2006 and 2009. Breast reconstruction trends also changed significantly over time, with a significant rise in the rate of free flap reconstruction to 58.8% between 2006 and 2009.

Conclusions

Our results demonstrated a significant decrease in unilateral mastectomy with a rise in bilateral mastectomy after the period 1996–2000, a period which encompassed the year when genetic testing of the two BRCA1/2 genes became commercially available, hence supporting our hypothesis.
Literature
1.
Tuttle T, Habermann E, Grund E, et al. Increasing use of contralateral prophylactic mastectomy among breast cancer patients: a trend toward more aggressive surgical treatment. Ann Surg Oncol. 2007;14(2 supplement):7.
2.
Tuttle TM. Management of the contralateral breast in women with breast cancer. Cancer Res. 2009;69 (Suppl.)(2):62s.
3.
Throckmorton AD, Esserman LJ. When informed, all women do not prefer breast conservation. J Clin Oncol. 2009;27(4):484–6.PubMedCrossRef
4.
Sorbero ME, Dick AW, Beckjord EB, Ahrendt G. Diagnostic breast magnetic resonance imaging and contralateral prophylactic mastectomy. Ann Surg Oncol. 2009;16(6):1597–605.PubMedCrossRef
5.
Meijers-Heijboer H, van Geel B, van Putten WL, et al. Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med. 2001;345(3):159–64.PubMedCrossRef
6.
Tuttle TM. Magnetic resonance imaging and contralateral prophylactic mastectomy: the “no mas” effect? Ann Surg Oncol. 2009;16(6):1461–2.PubMedCrossRef
7.
Press N, Reynolds S, Pinsky L, et al. ‘That’s like chopping off a finger because you’re afraid it might get broken’: disease and illness in women’s views of prophylactic mastectomy. Soc Sci Med. 2005;61(5):1106–17.PubMedCrossRef
8.
Stolier AJ, Fuhrman GM, Mauterer L, et al. Initial experience with surgical treatment planning in the newly diagnosed breast cancer patient at high risk for BRCA-1 or BRCA-2 mutation. Breast J. 2004;10(6):475–80.PubMedCrossRef
9.
Schwartz MD, Lerman C, Brogan B, et al. Impact of BRCA1/BRCA2 counseling and testing on newly diagnosed breast cancer patients. J Clin Oncol. 2004;22(10):1823–9.PubMedCrossRef
10.
Weitzel JN, McCaffrey SM, Nedelcu R, et al. Effect of genetic cancer risk assessment on surgical decisions at breast cancer diagnosis. Arch Surg. 2003;138(12):1323–8; discussion 1329.PubMedCrossRef
11.
Metcalfe KA, Narod SA. Breast cancer risk perception among women who have undergone prophylactic bilateral mastectomy. J Natl Cancer Inst. 2002;94(20):1564–9.PubMed
12.
Tuttle TM, Habermann EB, Grund EH, et al. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25(33):5203–9.PubMedCrossRef
13.
Metcalfe KA, Lubinski J, Ghadirian P, et al. Predictors of contralateral prophylactic mastectomy in women with a BRCA1 or BRCA2 mutation: the Hereditary Breast Cancer Clinical Study Group. J Clin Oncol. 2008;26(7):1093–7.PubMedCrossRef
Metadata
Title
Breast Cancer Surgery Trend Changes Since the Introduction of BRCA1/2 Mutation Screening: A Retrospective Cohort Analysis of 158 Mutation Carriers Treated at a Single Institution
Authors
Angela Mislowsky, MD
Susan Domchek, MD
Cecilia Stroede, MD
Meredith R. Bergey, MS
Seema S. Sonnad, PhD
Liza Wu, MD
Julia Tchou, MD, PhD
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 3/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1381-9

Other articles of this Issue 3/2011

Annals of Surgical Oncology 3/2011 Go to the issue

Thoracic Oncology

Thoracoscopic Esophagectomy in Prone Position

Pancreatic Tumors

Preoperative Capecitabine and Concurrent Radiation for Borderline Resectable Pancreatic Cancer

Translational Research and Biomarkers

Expression and Clinical Significance of Hepatoma-Derived Growth Factor as a Prognostic Factor in Human Hilar Cholangiocarcinoma

Breast Oncology

Sentinel Lymph Node Biopsy in Patients with Previous Ipsilateral Complete Axillary Lymph Node Dissection

Bone and Soft Tissue Sarcomas

Myxofibrosarcoma: Prognostic Factors and Survival in a Series of Patients Treated at a Single Institution

Translational Research and Biomarkers

Prognostic Significance of CD151 Expression in Esophageal Squamous Cell Carcinoma with Aggressive Cell Proliferation and Invasiveness