TY - JOUR
T1 - Post-mastectomy surveillance of BRCA1/BRCA2 mutation carriers
T2 - Outcomes from a specialized clinic for high-risk breast cancer patients
AU - Kanana, Nayroz
AU - Ben David, Meirav A.
AU - Nissan, Noam
AU - Yagil, Yael
AU - Shalmon, Anat
AU - Halshtok, Osnat
AU - Gotlieb, Michael
AU - Faermann, Renata
AU - Klang, Eyal
AU - Samoocha, David
AU - Yassin, Mohammad
AU - Davidson, Tima
AU - Zippel, Dov
AU - Madorsky Feldman, Dana
AU - Friedman, Eitan
AU - Kaidar-Person, Orit
AU - Sklair Levy, Miri
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/5
Y1 - 2021/5
N2 - Female BRCA1/BRCA2 mutation carriers may elect bilateral risk-reducing mastectomy. There is a paucity of data on yield of imaging surveillance after risk-reducing mastectomy. This retrospective study focused on female BRCA1/BRCA2 mutation carriers who underwent bilateral mastectomy either as primary preventative, or as secondary preventative, after breast cancer diagnosis. All participants underwent breast imaging at 6- to 12-month intervals after mastectomy. Data on subsequent breast cancer diagnosis and timing were collected and compared between the groups. Overall, 184 female mutation carriers (134 BRCA1, 45 BRCA2, 5 both BRCA genes) underwent bilateral mastectomy after initial breast cancer diagnosis, between April 1, 2009 and August 31, 2018. During a mean follow-up of 6.2 ± 4.2 years, 13 (7.06%) were diagnosed with breast cancer; 12 ipsilateral (range: 0.4–28.8 years) and 1 contralateral breast cancer, 15.9 years after surgery. On the contrary, among asymptomatic BRCA1 (n = 40) and BRCA2 (n = 13) mutation carriers who underwent primary risk-reducing mastectomy (mean age at surgery 39.5 ± 8.4 years); none has developed breast cancer after a mean follow-up of 5.4 ± 3.4 years. BRCA1/BRCA2 mutation carriers with prior disease who underwent risk-reducing mastectomy after breast cancer diagnosis are still prone for developing ipsi or contralateral breast cancer, and therefore may benefit from continues clinical and imaging surveillance, unlike BRCA1/BRCA2 mutation carriers who undergo primary preventative bilateral mastectomy.
AB - Female BRCA1/BRCA2 mutation carriers may elect bilateral risk-reducing mastectomy. There is a paucity of data on yield of imaging surveillance after risk-reducing mastectomy. This retrospective study focused on female BRCA1/BRCA2 mutation carriers who underwent bilateral mastectomy either as primary preventative, or as secondary preventative, after breast cancer diagnosis. All participants underwent breast imaging at 6- to 12-month intervals after mastectomy. Data on subsequent breast cancer diagnosis and timing were collected and compared between the groups. Overall, 184 female mutation carriers (134 BRCA1, 45 BRCA2, 5 both BRCA genes) underwent bilateral mastectomy after initial breast cancer diagnosis, between April 1, 2009 and August 31, 2018. During a mean follow-up of 6.2 ± 4.2 years, 13 (7.06%) were diagnosed with breast cancer; 12 ipsilateral (range: 0.4–28.8 years) and 1 contralateral breast cancer, 15.9 years after surgery. On the contrary, among asymptomatic BRCA1 (n = 40) and BRCA2 (n = 13) mutation carriers who underwent primary risk-reducing mastectomy (mean age at surgery 39.5 ± 8.4 years); none has developed breast cancer after a mean follow-up of 5.4 ± 3.4 years. BRCA1/BRCA2 mutation carriers with prior disease who underwent risk-reducing mastectomy after breast cancer diagnosis are still prone for developing ipsi or contralateral breast cancer, and therefore may benefit from continues clinical and imaging surveillance, unlike BRCA1/BRCA2 mutation carriers who undergo primary preventative bilateral mastectomy.
KW - BRCA1/BRCA2 mutation carriers
KW - MRI
KW - breast cancer risk
KW - mastectomy
KW - risk-reducing surgery
KW - surveillance scheme
UR - http://www.scopus.com/inward/record.url?scp=85100993052&partnerID=8YFLogxK
U2 - 10.1111/tbj.14190
DO - 10.1111/tbj.14190
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C2 - 33576117
AN - SCOPUS:85100993052
SN - 1075-122X
VL - 27
SP - 441
EP - 447
JO - Breast Journal
JF - Breast Journal
IS - 5
ER -