title: Contralateral risk reducing mastectomy in Non-BRCA-Mutated patients.
abstract: The use of contralateral risk reducing mastectomy (CRRM) is indicated in women affected by breast cancer, who are at high risk of developing a contralateral breast cancer, particularly women with genetic mutation of BRCA1, BRCA2 and P53. However we should consider that the genes described above account for only 20-30% of the excess familiar risk. What is contralaterally indicated when genetic assessment results negative for mutation in a young patient with unilateral breast cancer? Is it ethically correct to remove a contralateral "healthy" breast? CRRM rates continue to rise all over the world although CRRM seems not to improve overall survival in women with unilateral sporadic breast cancer. The decision to pursue CRRM as part of treatment in women who have a low-to-moderate risk of developing a secondary cancer in the contralateral breast should consider both breast cancer individual-features and patients preferences, but should be not supported by the surgeon and avoided as first approach with the exception of women highly worried about cancer. Prospective studies are needed to identify cohorts of patients most likely to benefit from CRRM.
authors.affiliation: Breast Surgery Unit Arcispedale-IRCCS Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Falco
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Rocco
authors.affiliation: Department of Senology, "Santa Maria della Mi-sericordia" Hospital, Urbino, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Bordoni
authors.affiliation: Robotic Surgery Unit, "San Matteo degli Infermi" Hospital - ASL Umbria 2, 06049, Spoleto (PG), Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Marano
authors.affiliation: Department of Gastroenterology, Endocrinology and Surgery, Breast Unit, AOU "Federico II", Naples, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Accurso
authors.affiliation: Department of Advanced Biomedical Sciences, Naples, Italy, University "Federico II" of Naples, via S. Pan-sini,5, 80131 Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Buccelli
authors.affiliation: Department of Advanced Biomedical Sciences, Naples, Italy, University "Federico II" of Naples, via S. Pan-sini,5, 80131 Naples, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Di Lorenzo
authors.affiliation: Department of Advanced Biomedical Sciences, Naples, Italy, University "Federico II" of Naples, via S. Pan-sini,5, 80131 Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Capasso
authors.affiliation: Department of Advanced Biomedical Sciences, Naples, Italy, University "Federico II" of Naples, via S. Pan-sini,5, 80131 Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Policino
authors.affiliation: Department of Advanced Biomedical Sciences, Naples, Italy, University "Federico II" of Naples, via S. Pan-sini,5, 80131 Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Niola
authors.affiliation: Breast Surgery Unit Arcispedale-IRCCS Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ferrari
keywords: Breast Cancer; Non-mutated patients; contralateral risk reducing mastectomy