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. 2024 Oct;130(5):990-996.
doi: 10.1002/jso.27817. Epub 2024 Sep 1.

Factors influencing prophylactic surgical intervention in women with genetic predisposition for breast cancer

Pooja Humar  1   2 , Zainab Balogun  1 , Nerone Douglas  1   2 , Anne Glenney  2 , Nicolás M Kass  1   2 , Elizabeth A Moroni  2 , Phuong L Mai  3 , Emilia Diego  4 , Carolyn De La Cruz  2
Affiliations

Factors influencing prophylactic surgical intervention in women with genetic predisposition for breast cancer

Pooja Humar et al. J Surg Oncol. 2024 Oct.

Abstract

Introduction: In the United States, 5%-10% of breast cancer cases are due to genetic predisposition. Among this population, prophylactic mastectomy is viable risk-reducing option.

Objective: The objective of this study is to understand the timing to prophylactic mastectomy in patients with genetic predisposition to breast cancer and uncover factors influencing this decision.

Methods: This study is a retrospective review of patients diagnosed with genetic predisposition for breast cancer from 2010 to 2020.

Results: In a cohort of 506 patients with genetic predisposition for breast cancer, 154 (30.4%) underwent prophylactic mastectomy, the remainder opted for surveillance alone. The median time from diagnosis to mastectomy was 1.1 years (IQR, 0.5-3.1 years). During the surveillance period, 118 patients (33.5%) underwent breast biopsy. Of the patients with benign or atypical findings, 35 (36.8%) pursued prophylactic mastectomy, a median of 0.5 years (IQR, 0.2-1.6 years) after their gene diagnosis. The most common factor impacting the decision to undergo prophylactic mastectomy was having a family member with cancer (54.7%) followed by a personal diagnosis of other cancer(s) (27.5%).

Conclusion: Understanding the factors influencing the decision to undergo prophylactic surgery will allow for more effective shared decision-making for primary care providers, breast surgeons, and reconstructive surgeons.

Keywords: BRCA; breast reconstruction; genetic predisposition; mastectomy; prophylactic.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Diagram of cohort accrual.
Figure 2
Figure 2
Breakdown of time to prophylactic mastectomy.
Figure 3
Figure 3
Diagram showing patients who choose prophylactic mastectomy versus surveillance only route.
Figure 4
Figure 4
Breakdown of social motivation in pursuing prophylactic surgical intervention.
See this image and copyright information in PMC

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