Impact of Prophylactic Mastectomy in BRCA1/2 Mutation Carriers

Breast Care
Kerstin Rhiem, R Schmutzler

Abstract

Unlike the general decrease in invasive oncologic care, the trend for prophylactic bilateral mastectomy in healthy women and prophylactic contralateral mastectomy in women with unilateral breast cancer is steadily rising. This is even more surprising when considering that for e.g. prophylactic contralateral mastectomy no clear survival benefit has been demonstrated so far. The decision-making process around risk-reducing surgery may be influenced by several conflicting parameters such as the patient's fears and desire to achieve a survival advantage, the surgeon's financial motivations, or the oncologist's paternalistic approach to the above trend. Physicians should support their patients throughout the decision-making process, guide them through the dense fog of information, and encourage them to reconsider all options and alternatives before embarking on an irreversible surgical intervention. Healthy and diseased women should be comprehensively informed about their absolute individual risks for cancer, the benefits and harms of the surgery, alternative preventive strategies, and last but not least the competing risks of preceding carcinomas and cancer in general. Within the framework of non-directive counseling in the special...Continue Reading

Citations

Oct 21, 2016·Clinical Obstetrics and Gynecology·Trevor Tejada-Bergés
Mar 5, 2016·Oncotarget·Javier A MenendezTomás Alarcón
Sep 16, 2019·European Journal of Medical Research·Michael G SchrauderMichael P Lux

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