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Open AccessCase Report

Challenges and Considerations on Risk-Reducing Surgery in BRCA1/2 Patients with Advanced Breast Cancer

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Medical Oncology Department, Hospital São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, 1449-005 Lisboa, Portugal
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Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
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Faculty of Health Sciences, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
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Oncology Unit, Centro Hospitalar do Oeste, 2500-176 Caldas da Rainha, Portugal
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Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
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Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(1), 485-490; https://doi.org/10.3390/curroncol28010050
Received: 26 November 2020 / Revised: 8 January 2021 / Accepted: 11 January 2021 / Published: 14 January 2021
Cancer survivors harboring inherited pathogenic variants in the breast cancer (BC) susceptibility genes BRCA1 or BRCA2 are at increased risk of ovarian cancer (OC) and also of contralateral BC. For these women, risk-reducing surgery (RRS) may contribute to risk management. However, women with locally advanced or metastatic breast cancer (ABC) were excluded from clinical trials evaluating the benefit of these procedures in the BRCA1/2 carriers, and thus, current guidelines do not recommend RRS in this specific setting. Although ABC remains an incurable disease, recent advances in treatment have led to increased survival, which, together with improvement in RRS techniques, raise questions about the potential role of RRS in the management of BRCA1/2 ABC patients. When should RRS be discussed as an option for BRCA1/2 patients diagnosed with ABC? To address this issue, we report two clinical cases that reflect new challenges in routine oncology practice. Team experience and patient motivations may shape multidisciplinary decisions in the absence of evidence-based data. A wise rationale may be the analysis of the competing risks of death by a previous ABC against risk of death by a secondary BC or OC, tailored to patient preferences. View Full-Text
Keywords: breast cancer; ovarian cancer; hereditary cancer; BRCA; risk-reducing surgery breast cancer; ovarian cancer; hereditary cancer; BRCA; risk-reducing surgery
MDPI and ACS Style

Vasconcelos de Matos, L.; Fernandes, L.; Louro, P.; Plácido, A.; Barros, M.; Vaz, F. Challenges and Considerations on Risk-Reducing Surgery in BRCA1/2 Patients with Advanced Breast Cancer. Curr. Oncol. 2021, 28, 485-490. https://doi.org/10.3390/curroncol28010050

AMA Style

Vasconcelos de Matos L, Fernandes L, Louro P, Plácido A, Barros M, Vaz F. Challenges and Considerations on Risk-Reducing Surgery in BRCA1/2 Patients with Advanced Breast Cancer. Current Oncology. 2021; 28(1):485-490. https://doi.org/10.3390/curroncol28010050

Chicago/Turabian Style

Vasconcelos de Matos, Leonor; Fernandes, Leonor; Louro, Pedro; Plácido, Ana; Barros, Manuel; Vaz, Fátima. 2021. "Challenges and Considerations on Risk-Reducing Surgery in BRCA1/2 Patients with Advanced Breast Cancer" Curr. Oncol. 28, no. 1: 485-490. https://doi.org/10.3390/curroncol28010050

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