title: Surgical Decision Making in the BRCA-Positive Population: Institutional Experience and Comparison with Recent Literature.
abstract: A retrospective study was performed to document the uptake and extent of surgical intervention in patients with a known mutation in the BRCA1/2 genes and associated outcomes. Data were collected retrospectively on BRCA-positive patients with and without cancer at the time of genetic testing. Our findings were compared to those published in the current literature. Of patients with cancer at testing, 61% chose bilateral mastectomies. Of patients without cancer, 54% chose risk-reducing surgery (RRS) including risk-reducing mastectomy (RRM), risk-reducing salpingo-oophorectomy (RRSO), or both. Time to surgery was significantly shorter to RRSO than to RRM. The literature suggests and our data support that acceptance of RRM in the BRCA-positive population has gradually increased over time. Consistently high rates of RRSO uptake and short intervals from time-of-testing to RRSO demonstrate that RRSO is still more acceptable to this population than RRM.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Teresa
authors.initials: T
authors.lastname: Flippo-Morton
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Kendall
authors.initials: K
authors.lastname: Walsh
authors.affiliation: Department of Surgery, Cornerstone Breast Care, High Point, North Carolina.
authors.forename: Karinn
authors.initials: K
authors.lastname: Chambers
authors.affiliation: Clinical Genetics Program, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Lisa
authors.initials: L
authors.lastname: Amacker-North
authors.affiliation: Clinical Genetics Program, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Brook
authors.initials: B
authors.lastname: White
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Terry
authors.initials: T
authors.lastname: Sarantou
authors.affiliation: Department of Cancer Biostatistics, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Boselli
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Richard L
authors.initials: RL
authors.lastname: White
mesh_terms: D000328:Adult; D000367:Age Factors; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics* / Q000601:surgery*; D003657:Decision Making; D017558:Elective Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009154:Mutation; D010052:Ovariectomy; D012189:Retrospective Studies
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: BRCA1/2; breast cancer; high-risk surveillance; mastectomy; salpingo-oophorectomy