title: Surgical decisions made by 158 women with hereditary breast cancer aged <50 years.
abstract: OBJECTIVE
  To establish the uptake of contralateral risk reducing mastectomy in women informed of their risks and options at time of diagnosis of their primary unilateral breast cancer.
  
  
  METHODS
  We have assessed the surgical choices of 70 women diagnosed with breast cancer <50 years as part of a family history surveillance program and fully informed about their contralateral risks and surgical options. We have compared this to women from other surgical clinics who were subsequently found to harbour a pathogenic BRCA1/2 mutation.
  
  
  RESULTS
  Sixty-five percent (13/20) of BRCA1/2 mutation carriers and 59% (n=20/34) of those at the highest level of risk pre-diagnosis (33+% lifetime risk) opted for contra-lateral mastectomy in the study sample. In contrast only 10% (n=9/88) women identified as mutation carriers from other clinics opted for such surgery.
  
  
  CONCLUSIONS
  We would suggest that women with a significant family history and therefore a high contra-lateral breast cancer risk, should have these risks and management options discussed at the time of diagnosis of breast cancer.
authors: Academic Unit of Medical Genetics and Regional Genetics Service, St Mary's Hospital, Hathersage Road, Manchester, UK. gareth.evans@cmmc.nhs.uk
authors: D G R
authors: DG
authors: Evans
authors: F
authors: F
authors: Lalloo
authors: P
authors: P
authors: Hopwood
authors: A
authors: A
authors: Maurice
authors: A
authors: A
authors: Baildam
authors: A
authors: A
authors: Brain
authors: L
authors: L
authors: Barr
authors: A
authors: A
authors: Howell
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology / Q000601:surgery*; D002755:Choice Behavior; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D005820:Genetic Testing; D006801:Humans; D008403:Mass Screening; D008408:Mastectomy / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D012307:Risk Factors