abstract
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.
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