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Open AccessArticle

Prophylactic Surgery in the BRCA+ Patient: Do Women Develop Breast Cancer While Waiting?

1
Division of Plastic & Reconstructive Surgery, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
2
Department of Surgery, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
3
Department of Medical Oncology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
4
Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(1), 702-715; https://doi.org/10.3390/curroncol28010069
Received: 13 November 2020 / Revised: 7 January 2021 / Accepted: 15 January 2021 / Published: 25 January 2021
Breast cancer susceptibility gene (BRCA) mutation carriers have an increased risk of breast cancer. Mitigation of this risk can be achieved via surveillance or prophylactic mastectomy with or without breast reconstruction. Those that choose surgery expect to reduce their chance of developing cancer. The purpose of this study was to determine the incidence of patients developing breast cancer prior to surgery and to identify modifiable contributing factors within the patient journey. This is a historical cohort study of all BRCA mutation carriers identified through the British Columbia Cancer Hereditary Cancer Program between 2000 and 2012. Patients were divided into two groups: surveillance (S) and prophylactic mastectomy with immediate breast reconstruction (PM/IBR). The incidence of cancer, time to PM/IBR and patient journeys were analyzed. A total of 333 women were identified. The time to surgery from mutation disclosure was a median of 31 (5.3, 75.7) months. During this period, 6% of patients developed breast cancer compared with a 14% incidence of breast cancer in patients choosing surveillance. The majority of time to surgery was attributed to the period between mutation disclosure and the decision to proceed with surgery. Strategies to facilitate decision-making as well as wait list prioritization and dedicated operative time should be targeted to this population to decrease the number of women developing an interval cancer prior to surgery. View Full-Text
Keywords: BRCA; breast cancer; breast reconstruction; prophylactic surgery BRCA; breast cancer; breast reconstruction; prophylactic surgery
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MDPI and ACS Style

Macadam, S.A.; Slater, K.; Cheifetz, R.E.; Jansen, L.; Chia, S.; Brasher, P.M.A.; Bovill, E.S. Prophylactic Surgery in the BRCA+ Patient: Do Women Develop Breast Cancer While Waiting? Curr. Oncol. 2021, 28, 702-715. https://doi.org/10.3390/curroncol28010069

AMA Style

Macadam SA, Slater K, Cheifetz RE, Jansen L, Chia S, Brasher PMA, Bovill ES. Prophylactic Surgery in the BRCA+ Patient: Do Women Develop Breast Cancer While Waiting? Current Oncology. 2021; 28(1):702-715. https://doi.org/10.3390/curroncol28010069

Chicago/Turabian Style

Macadam, Sheina A.; Slater, Karen; Cheifetz, Rona E.; Jansen, Leigh; Chia, Stephen; Brasher, Penelope M.A.; Bovill, Esta S. 2021. "Prophylactic Surgery in the BRCA+ Patient: Do Women Develop Breast Cancer While Waiting?" Curr. Oncol. 28, no. 1: 702-715. https://doi.org/10.3390/curroncol28010069

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