title: Outcomes of Concurrent Breast and Gynecologic Risk Reduction Surgery.
abstract: BACKGROUND
  Women considering risk reduction surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated multispecialty surgery.
  
  
  METHODS
  We conducted a retrospective review of patients undergoing simultaneous breast and gynecologic surgery for newly or previously diagnosed breast cancer and/or an inherited cancer gene mutation during the same anesthetic at a single institution from 1999 to 2013.
  
  
  RESULTS
  Seventy-three patients with a mean age of 50 years (range 27-88) were identified. Most patients had newly diagnosed breast cancer or ductal carcinoma in situ (62 %) and 28 patients (38 %) had an identified BRCA mutation. Almost all gynecologic procedures were for risk reduction or benign gynecologic conditions (97 %). Mastectomy was performed in 39 patients (53 %), the majority of whom (79 %) underwent immediate reconstruction. The most common gynecologic procedure involved bilateral salpingo-oophorectomy, which was performed alone in 18 patients (25 %) and combined with hysterectomy in 40 patients (55 %). A total of 32 patients (44 %) developed postoperative complications, most of which were minor and did not require surgical intervention or hospitalization. Two of the 19 patients who underwent implant reconstruction (11 %; 3 % of the entire cohort) had major infectious complications requiring explantation.
  
  
  CONCLUSIONS
  Combined breast and gynecologic procedures for a breast cancer diagnosis and/or risk reduction in patients can be accomplished with acceptable morbidity. Concurrent operations, including reconstruction, can be offered to patients without negatively impacting their outcome.
authors: Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Irene T
authors: IT
authors: Ma
authors: Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Richard J
authors: RJ
authors: Gray
authors: Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Nabil
authors: N
authors: Wasif
authors: Department of Gynecology, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Kristina A
authors: KA
authors: Butler
authors: Department of Gynecology, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Jeffrey L
authors: JL
authors: Cornella
authors: Department of Gynecology, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Javier F
authors: JF
authors: Magrina
authors: Department of Gynecology, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Paul M
authors: PM
authors: Magtibay
authors: Division of Plastic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: William J
authors: WJ
authors: Casey
authors: Division of Plastic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Raman
authors: R
authors: Mahabir
authors: Division of Plastic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Alanna M
authors: AM
authors: Rebecca
authors: Division of Hematology/Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA.
authors: Katherine S
authors: KS
authors: Hunt
authors: Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA. Pockaj.Barbara@mayo.edu.
authors: Barbara A
authors: BA
authors: Pockaj
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics / Q000601:surgery*; D002278:Carcinoma in Situ / Q000235:genetics / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000235:genetics / Q000601:surgery*; D005260:Female; D020022:Genetic Predisposition to Disease; D005833:Genital Neoplasms, Female / Q000235:genetics / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D000074868:Salpingo-oophorectomy; D016896:Treatment Outcome