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Surgical Decision Making in the BRCA‐Positive Population: Institutional Experience and Comparison with Recent Literature
Authors:Teresa Flippo‐Morton MD  FACS  Kendall Walsh CCRP  Karinn Chambers MD  Lisa Amacker‐North MS  CGC  Brook White MS  CGC  Terry Sarantou MD  FACS  Danielle M. Boselli MS  Richard L. White MD  FACS Jr.
Affiliation:1. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina;2. Department of Surgery, Cornerstone Breast Care, High Point, North Carolina;3. Clinical Genetics Program, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina;4. Department of Cancer Biostatistics, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
Abstract:A retrospective study was performed to document the uptake and extent of surgical intervention in patients with a known mutation in the BRCA1/2 genes and associated outcomes. Data were collected retrospectively on BRCA‐positive patients with and without cancer at the time of genetic testing. Our findings were compared to those published in the current literature. Of patients with cancer at testing, 61% chose bilateral mastectomies. Of patients without cancer, 54% chose risk‐reducing surgery (RRS) including risk‐reducing mastectomy (RRM), risk‐reducing salpingo‐oophorectomy (RRSO), or both. Time to surgery was significantly shorter to RRSO than to RRM. The literature suggests and our data support that acceptance of RRM in the BRCA‐positive population has gradually increased over time. Consistently high rates of RRSO uptake and short intervals from time‐of‐testing to RRSO demonstrate that RRSO is still more acceptable to this population than RRM.
Keywords:BRCA1/2  breast cancer  high‐risk surveillance  mastectomy  salpingo‐oophorectomy
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