abstract
BACKGROUND:
Women
considering risk reduction surgery after a diagnosis of breast/ovarian
cancer and/or inherited cancer gene mutation face difficult decisions.
The safety of combined breast and gynecologic surgery has not been well
studied; therefore, we evaluated the outcomes for patients who have
undergone coordinated multispecialty surgery.
METHODS:
We
conducted a retrospective review of patients undergoing simultaneous
breast and gynecologic surgery for newly or previously diagnosed breast
cancer and/or an inherited cancer gene mutation during the same
anesthetic at a single institution from 1999 to 2013.
RESULTS:
Seventy-three
patients with a mean age of 50 years (range 27-88) were identified.
Most patients had newly diagnosed breast cancer or ductal carcinoma in
situ (62 %) and 28 patients (38 %) had an identified BRCA mutation.
Almost all gynecologic procedures were for risk reduction or benign
gynecologic conditions (97 %). Mastectomy was performed in 39 patients
(53 %), the majority of whom (79 %) underwent immediate reconstruction.
The most common gynecologic procedure involved bilateral
salpingo-oophorectomy, which was performed alone in 18 patients (25 %)
and combined with hysterectomy in 40 patients (55 %). A total of 32
patients (44 %) developed postoperative complications, most of which
were minor and did not require surgical intervention or hospitalization.
Two of the 19 patients who underwent implant reconstruction (11 %; 3 %
of the entire cohort) had major infectious complications requiring
explantation.
CONCLUSION:
Combined
breast and gynecologic procedures for a breast cancer diagnosis and/or
risk reduction in patients can be accomplished with acceptable
morbidity. Concurrent operations, including reconstruction, can be
offered to patients without negatively impacting their outcome.
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