title: The frequency and outcome of breast cancer risk-reducing surgery in Finnish BRCA1 and BRCA2 mutation carriers.
abstract: OBJECTIVE
  Risk-reducing mastectomy of BRCA1 and BRCA2 gene mutation carriers is known to significantly reduce lifetime risk of breast cancer. Our aim was to study the frequency and outcome of risk-reducing mastectomies performed in Helsinki University Central Hospital during 1997-2010.
  
  
  METHODS
  In testing for mutations in BRCA1 and BRCA2, 136 female carriers had been identified and followed up in Helsinki University Central Hospital.
  
  
  RESULTS
  A total of 69 breasts in 52 women were operated on for risk-reduction, including 28 (54%) bilateral mastectomies at mean age of 43 years. Autologous tissue was used for reconstruction in 40 (50%) and implants in 31 (39%) of the breasts, respectively. In all, 8 patients (15%) chose to have no reconstruction. Minor or major complications were recorded in 21 (40%) patients. Five reconstructions failed and were corrected with re-reconstruction.
  
  
  CONCLUSIONS
  In this series of Finnish BRCA1 and BRCA2 mutation carriers, a high percentage 52 (41%) chose risk-reducing breast surgery. Autologous tissue was favored in breast reconstructions. Immediate breast reconstructions were associated with a relatively high risk of complications in free flaps and in implant reconstructions, but not in latissimus dorsi reconstructions. It is mandatory that patients are informed about the risks associated with risk-reducing operations.
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Koskenvuo
authors.forename: C
authors.initials: C
authors.lastname: Svarvar
authors.forename: S
authors.initials: S
authors.lastname: Suominen
authors.forename: K
authors.initials: K
authors.lastname: Aittomäki
authors.forename: T
authors.initials: T
authors.lastname: Jahkola
mesh_terms: D000328:Adult; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005819:Genetic Markers; D005820:Genetic Testing; D061325:Hereditary Breast and Ovarian Cancer Syndrome / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D006801:Humans; D016462:Mammaplasty / Q000379:methods / Q000706:statistics & numerical data*; D008408:Mastectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D009154:Mutation; D016896:Treatment Outcome
chemical_list: D005819:Genetic Markers
keywords: BRCA1; BRCA2; complications; immediate breast reconstruction; prophylaxis; risk-reducing mastectomy