title: International rates of breast reconstruction after prophylactic mastectomy in BRCA1 and BRCA2 mutation carriers.
abstract: BACKGROUND
  Breast reconstruction is an option for women with BRCA1 or BRCA2 mutations who elect to undergo prophylactic mastectomy to prevent breast cancer. We report on the uptake of breast reconstruction after prophylactic mastectomy in women with BRCA mutations from eight countries.
  
  
  METHODS
  Women with a BRCA1 or BRCA2 mutation were questioned regarding their cancer preventive practices. Information was recorded on prophylactic mastectomy and breast reconstruction.
  
  
  RESULTS
  A total of 1,635 women with a BRCA1 or BRCA2 mutation who elected to undergo prophylactic mastectomy from eight countries were included. A total of 1,137 women (69.5%) had breast reconstruction after prophylactic mastectomy. A total of 58.7% of women over the age of 45 years at the time of prophylactic mastectomy had breast reconstruction compared to 77.6% of women 35 years of age or younger [odds ratio (OR) 0.36, 95% confidence interval (CI) 0.26-0.50, p < 0.001]. In addition, 62.9% of women with a breast cancer diagnosis (contralateral prophylactic mastectomy) had breast reconstruction after prophylactic mastectomy compared to 79.7% of women without a previous breast cancer diagnosis (OR 0.48, 95% CI 0.38-0.61, p < 0.001). A total of 66.9% of women from Canada had breast reconstruction after mastectomy compared to 71.9% of American women (OR 0.75, 95% CI 0.59-0.96, p = 0.02).
  
  
  CONCLUSIONS
  The majority of women elect for breast reconstruction after prophylactic mastectomy. However, younger women and those without a previous diagnosis of breast cancer are more likely to have breast reconstruction than older women or those with a previous diagnosis of cancer.
authors.affiliation: Women's College Research Institute, Toronto, ON, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Semple
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Metcalfe
authors.forename: Henry T
authors.initials: HT
authors.lastname: Lynch
authors.forename: Charmaine
authors.initials: C
authors.lastname: Kim-Sing
authors.forename: Leigha
authors.initials: L
authors.lastname: Senter
authors.forename: Tuya
authors.initials: T
authors.lastname: Pal
authors.forename: Peter
authors.initials: P
authors.lastname: Ainsworth
authors.forename: Jan
authors.initials: J
authors.lastname: Lubinski
authors.forename: Nadine
authors.initials: N
authors.lastname: Tung
authors.forename: Charis
authors.initials: C
authors.lastname: Eng
authors.forename: Donna
authors.initials: D
authors.lastname: Gilchrist
authors.forename: Joanne
authors.initials: J
authors.lastname: Blum
authors.forename: Susan L
authors.initials: SL
authors.lastname: Neuhausen
authors.forename: Christian F
authors.initials: CF
authors.lastname: Singer
authors.forename: Parviz
authors.initials: P
authors.lastname: Ghadirian
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.forename: Steven A
authors.initials: SA
authors.lastname: Narod
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D002170:Canada; D005260:Female; D005500:Follow-Up Studies; D006579:Heterozygote; D006801:Humans; D007390:International Agencies; D016462:Mammaplasty / Q000706:statistics & numerical data*; D008408:Mastectomy; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D011379:Prognosis; D055815:Young Adult
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human