title: Contralateral prophylactic mastectomy in breast cancer patients who test negative for BRCA mutations.
abstract: BACKGROUND
  Determination of BRCA1 and 2 mutation carrier status is important. Although BRCA carriers are offered bilateral mastectomy and oophorectomy, most who test negative decline. Some women choose contralateral prophylactic mastectomy (CPM) at the time of their breast cancer diagnosis despite testing negative.
  
  
  METHODS
  A total of 110 women with breast cancer received genetic testing before surgical treatment. Patient demographics, tumor characteristics, surgical treatment, and magnetic resonance imaging use were recorded.
  
  
  RESULTS
  Results revealed BRCA1/2 mutation in 33%, variant of unknown significance in 6%, and no mutation in 61% of women. In BRCA-negative women, 37% chose CPM. Marital status was significant for CPM (P = .03). Race, age, stage of presentation, and biomarker status were not associated with choice of CPM. Ninety-six percent of CPM recipients underwent breast reconstruction. Magnetic resonance imaging use did not affect CPM rates (P = .99).
  
  
  CONCLUSIONS
  Increased rates of CPM have been observed. In our study married women were more likely to choose CPM. We recommend genetic genotyping before surgery. These findings warrant further investigation.
authors.affiliation: Department of Surgical Oncology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1096, USA. mmcnatt@wfubmc.edu
authors.forename: Marissa
authors.initials: M
authors.lastname: Howard-McNatt
authors.forename: Rebecca W
authors.initials: RW
authors.lastname: Schroll
authors.forename: Gail J
authors.initials: GJ
authors.lastname: Hurt
authors.forename: Edward A
authors.initials: EA
authors.lastname: Levine
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005820:Genetic Testing; D006579:Heterozygote; D006801:Humans; D016462:Mammaplasty / Q000706:statistics & numerical data; D015411:Mastectomy, Modified Radical / Q000706:statistics & numerical data*; D008875:Middle Aged; D009154:Mutation; D009657:North Carolina / Q000453:epidemiology; D055502:Secondary Prevention / Q000379:methods* / Q000706:statistics & numerical data