Risk reduction and survival benefit of prophylactic surgery in BRCA mutation carriers, a systematic review. Am J Surg 2016 Oct;212(4):660-669
Date
09/22/2016Pubmed ID
27649974DOI
10.1016/j.amjsurg.2016.06.010Scopus ID
2-s2.0-84991709374 (requires institutional sign-in at Scopus site) 205 CitationsAbstract
BACKGROUND: Mutations in BRCA1 or BRCA2 genes results in an elevated risk for developing both breast and ovarian cancers over the lifetime of affected carriers. General surgeons may be faced with questions about surgical risk reduction and survival benefit of prophylactic surgery.
METHODS: A systematic literature review was performed using the electronic databases PubMed, OVID MEDLINE, and Scopus comparing prophylactic surgery vs observation with respect to breast and ovarian cancer risk reduction and mortality in BRCA mutation carriers.
RESULTS: Bilateral risk-reducing mastectomy provides a 90% to 95% risk reduction in BRCA mutation carriers, although the data do not demonstrate improved mortality. The reduction in ovarian and breast cancer risks using risk-reducing bilateral salpingo-oophorectomy has translated to improvement in survival.
CONCLUSIONS: Clinical management of patients at increased risk for breast cancer requires consideration of risk, patient preference, and quality of life.
Author List
Ludwig KK, Neuner J, Butler A, Geurts JL, Kong ALAuthors
Jennifer L. Geurts MS Director, Associate Professor in the Institute for Health and Humanity department at Medical College of WisconsinAmanda L. Kong MS, MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Breast NeoplasmsFemale
Genes, BRCA1
Genes, BRCA2
Heterozygote
Humans
Mutation
Ovarian Neoplasms
Ovariectomy
Prophylactic Mastectomy
Prophylactic Surgical Procedures
Salpingectomy
