Frequency of Contralateral Prophylactic Mastectomy in Breast Cancer Patients with a Negative BRCA1 and BRCA2 Rapid Genetic Test Result.


Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 29 12 2020
accepted: 29 01 2021
pubmed: 25 3 2021
medline: 12 8 2021
entrez: 24 3 2021
Statut: ppublish

Résumé

There is an increasing desire for contralateral prophylactic mastectomy (CPM) among patients with unilateral breast cancer. It is unknown if risk assessment and genetic testing at the time of diagnosis will aid women in their surgical choice. We report on the uptake and predictors of CPM in women receiving a negative genetic test result for BRCA1 and BRCA2 mutations before surgery. Women diagnosed with breast cancer between June 2013 and May 2018 were recruited from four academic health sciences centers in Toronto, Canada. Genetic counseling (risk assessment) and genetic testing was performed prior to surgery. Women were asked about their surgical preference before surgery. At 1 year post-surgery we asked what surgery was completed. This study reports on women who received a negative BRCA1/BRCA2 result. A total of 766 women with a mean age of 46 years (range 21-82) were included in the analysis. Before genetic counseling and testing, 37% of the women were undecided or leaning towards CPM; however, after receiving a negative BRCA test, 15% of the women opted for CPM. Thirty percent of women whose mother died of breast cancer elected for CPM, compared with 15% of women whose mother did not die of breast cancer (p = 0.03). Women receiving a risk assessment and negative BRCA1/BRCA2 genetic test result before surgery use this information to guide their surgical decision. Uptake of CPM for women who were planning on CPM before genetic testing decreases after receiving a negative BRCA1/BRCA2 genetic test result.

Sections du résumé

BACKGROUND BACKGROUND
There is an increasing desire for contralateral prophylactic mastectomy (CPM) among patients with unilateral breast cancer. It is unknown if risk assessment and genetic testing at the time of diagnosis will aid women in their surgical choice. We report on the uptake and predictors of CPM in women receiving a negative genetic test result for BRCA1 and BRCA2 mutations before surgery.
METHODS METHODS
Women diagnosed with breast cancer between June 2013 and May 2018 were recruited from four academic health sciences centers in Toronto, Canada. Genetic counseling (risk assessment) and genetic testing was performed prior to surgery. Women were asked about their surgical preference before surgery. At 1 year post-surgery we asked what surgery was completed. This study reports on women who received a negative BRCA1/BRCA2 result.
RESULTS RESULTS
A total of 766 women with a mean age of 46 years (range 21-82) were included in the analysis. Before genetic counseling and testing, 37% of the women were undecided or leaning towards CPM; however, after receiving a negative BRCA test, 15% of the women opted for CPM. Thirty percent of women whose mother died of breast cancer elected for CPM, compared with 15% of women whose mother did not die of breast cancer (p = 0.03).
CONCLUSIONS CONCLUSIONS
Women receiving a risk assessment and negative BRCA1/BRCA2 genetic test result before surgery use this information to guide their surgical decision. Uptake of CPM for women who were planning on CPM before genetic testing decreases after receiving a negative BRCA1/BRCA2 genetic test result.

Identifiants

pubmed: 33761021
doi: 10.1245/s10434-021-09855-6
pii: 10.1245/s10434-021-09855-6
doi:

Substances chimiques

BRCA1 Protein 0
BRCA1 protein, human 0
BRCA2 Protein 0
BRCA2 protein, human 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

4967-4973

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021. Society of Surgical Oncology.

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Auteurs

Kelly A Metcalfe (KA)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. kelly.metcalfe@utoronto.ca.
Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. kelly.metcalfe@utoronto.ca.

Andrea Eisen (A)

Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Aletta Poll (A)

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.

Alexandra Candib (A)

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.

David McCready (D)

Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.

Tulin Cil (T)

Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.

Frances Wright (F)

Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Rochelle Demsky (R)

Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.

Talia Mancuso (T)

Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Ping Sun (P)

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.

Steven A Narod (SA)

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.

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