title: [Surgical prevention  of breast carcinoma in patients with hereditary risk].
abstract: BACKGROUND
  Women with BRCA1 gene mutation have 85% risk of breast cancer; the risk for BRCA2 carriers is 45%. The aim of the study was to verify if prophylactic mastectomy with immediate breast reconstruction can prevent breast cancer in BRCA positive patients.
  
  
  METHODS
  There were 100 BRCA positive women in which prophylactic mastectomy with immediate reconstruction, 75 dieps, 25 with implants, performed in period 2000-2011. Group A was composed of healthy, non-affected 41 patients, group B of 59 patients in remission after breast cancer treatment. These groups were compared to group C that consisted of 219 healthy carriers of BRCA1/2, non-operated, from registry of genetic department of the Masaryk Memorial Cancer in Brno, from 2000-2011.
  
  
  METHODS
  Follow-up for oncology status was done in September 2011 for all 3 groups.
  
  
  RESULTS
  Average follow-up of 21 months revealed that in group A there was no breast cancer, in group B 4 patients died and 2 had treatment for metastases. In group C, there were 16 new cases of breast cancer.
  
  
  CONCLUSIONS
  Bilateral prophylactic mastectomy with immediate reconstruction can be an effective way in breast cancer prevention in healthy carriers of BRCA1/2 mutation. In BRCA positive patients treated for breast cancer, the effect of prophylactic mastectomy is unclear. Their survival is more influenced by their previous disease than by a new tumor in the breast.
authors.affiliation: Klinika plastické a estetické chirurgie, Fakultní nemocnice u sv. Anny v Brně. ldrazan@volny.cz
authors.forename: L
authors.initials: L
authors.lastname: Dražan
authors.forename: J
authors.initials: J
authors.lastname: Veselý
authors.forename: P
authors.initials: P
authors.lastname: Hýža
authors.forename: T
authors.initials: T
authors.lastname: Kubek
authors.forename: L
authors.initials: L
authors.lastname: Foretová
authors.forename: O
authors.initials: O
authors.lastname: Coufal
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D009154:Mutation; D055815:Young Adult