Clinical characteristics and choices regarding risk-reducing surgery in BRCA mutation carriers

Gynecol Obstet Invest. 2010;69(4):270-273. doi: 10.1159/000276573. Epub 2010 Jan 21.

Abstract

Background/aims: BRCA mutation carriers have a high lifetime risk of developing breast and ovarian malignancies. As genetic testing becomes widely available, preventative measures are a choice. We evaluated the characteristics of BRCA mutation carriers who chose prophylactic surgery (PS) compared to those who opted for surveillance.

Methods: A retrospective chart review of patients with a mutation in the BRCA1 or BRCA2 genes was performed.

Results: Ninety women were included, of whom 46 (51%) underwent PS. They were more likely to be a BRCA2 mutation carrier, parous, married, employed, and had a prior history of breast cancer. PS included 39 bilateral salpingo-oophorectomies and 13 mastectomies. Pathology was typically benign; however, 15% showed ductal carcinoma in situ of the breast, 8% reported infiltrating ductal carcinoma of the breast, 3% was adenocarcinoma of the fallopian tube, and 3% was adenocarcinoma of the ovary.

Conclusion: It is notable that BRCA1 mutation carriers were less inclined to elect for PS. Evaluating the reasons for pursuing PS among women with a BRCA mutation is necessary and will require a larger data set. Long-term follow-up is required to describe the potential side effects of PS on quality of life.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Apoptosis Regulatory Proteins
  • BRCA1 Protein / genetics*
  • BRCA2 Protein / genetics*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / prevention & control*
  • Employment
  • Fallopian Tube Neoplasms / genetics
  • Fallopian Tube Neoplasms / prevention & control
  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Marital Status
  • Mastectomy
  • Middle Aged
  • Mutation*
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / prevention & control*
  • Ovariectomy
  • Parity
  • Patient Preference
  • Pregnancy
  • Retrospective Studies

Substances

  • Apoptosis Regulatory Proteins
  • BLID protein, human
  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human