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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2014

01-10-2014 | Breast Oncology

Predictors that Influence Contralateral Prophylactic Mastectomy Election Among Women with Ductal Carcinoma In Situ Who Were Evaluated for BRCA Genetic Testing

Authors: Nisreen Elsayegh, MS, Henry M. Kuerer, MD, Heather Lin, MD, PhD, Angelica M. Gutierrez Barrera, MS, Michelle Jackson, MS, Kimberly I. Muse, MS, Jennifer K. Litton, MD, Constance Albarracin, MD, PhD, Aimaz Afrough, MD, Gabriel N. Hortobagyi, MD, Banu K. Arun, MD

Published in: Annals of Surgical Oncology | Issue 11/2014

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Abstract

Background

Patients with ductal carcinoma in situ (DCIS) are at increased risk for developing contralateral breast cancer (CBC). Consequently, more women with DCIS are electing to undergo contralateral prophylactic mastectomy (CPM). We evaluated factors associated with CPM in patients with DCIS who underwent genetic counseling for BRCA testing.

Methods

This retrospective study involved 165 women with DCIS referred for genetic counseling between 2003 and 2011. Patient characteristics were age, marital and educational status, tumor markers, nuclear grade, family history of breast cancer (BC) and ovarian cancer (OC), race, Ashkenazi Jewish ancestry, and BRCA results. Univariate and multivariate logistic regression analyses were used to determine predictive factors associated with CPM election.

Results

Of 165 patients, 44 (27 %) underwent CPM. Patients <45 years of age were more likely to elect CPM (p = 0.0098). A BRCA+ mutation was found in 17 patients (10.3 %), and BRCA+ women were more likely to elect CPM than BRCA or untested women (p = 0.0001). Patients who had a family history of OC (57.7 %) were more likely to choose CPM than those with no family history (p = 0.0004). Younger age, BRCA+, and an OC family history remained significant in the multivariate model (p < 0.008).

Conclusion

The CPM rate among patients with DCIS who undergo genetic counseling is high. Factors associated with increased likelihood of CPM among this group were age, BRCA+, and a family history of OC. Further studies are needed to evaluate patients’ perceptions of CBC risk and their role in the likelihood of CPM choice.
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Metadata
Title
Predictors that Influence Contralateral Prophylactic Mastectomy Election Among Women with Ductal Carcinoma In Situ Who Were Evaluated for BRCA Genetic Testing
Authors
Nisreen Elsayegh, MS
Henry M. Kuerer, MD
Heather Lin, MD, PhD
Angelica M. Gutierrez Barrera, MS
Michelle Jackson, MS
Kimberly I. Muse, MS
Jennifer K. Litton, MD
Constance Albarracin, MD, PhD
Aimaz Afrough, MD
Gabriel N. Hortobagyi, MD
Banu K. Arun, MD
Publication date
01-10-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 11/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3747-x

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