Institution: | 1. Radiology Department, Sheba Medical Center, Sheba Tel Ha'shomer, Ramat-gan, Israel;2. The Oncology Institute, Sheba Medical Center, Sheba Tel Ha'shomer, Ramat-gan, Israel;3. Meirav High Risk Clinic, Department of Diagnostic Imaging, Chaim Sheba Medical Center, Ramat-gan, Israel;4. Department of Nuclear Medicine, Sheba Medical Center, Sheba Tel Ha'shomer, Ramat-gan, Israel;5. Meirav High Risk Clinic, Department of Diagnostic Imaging, Chaim Sheba Medical Center, Ramat-gan, Israel
The Susanne Levy Gertner Oncogenetics Unit, Sheba Medical Center, Sheba Tel Ha'shomer, Ramat-gan, Israel
The Sackler school of medicine, Tel-Aviv University, Tel-Aviv, Israel;6. Breast Cancer Radiation Therapy Unit, Sheba Medical Center, Sheba Tel Ha'shomer, Ramat-gan, Israel
The Sackler school of medicine, Tel-Aviv University, Tel-Aviv, Israel
GROW-School for Oncology and Developmental Biology (Maastro, Maastricht University, Maastricht, The Netherlands;7. Meirav High Risk Clinic, Department of Diagnostic Imaging, Chaim Sheba Medical Center, Ramat-gan, Israel
The Sackler school of medicine, Tel-Aviv University, Tel-Aviv, Israel |
Abstract: | 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. |