Cited by 153BRCA gene mutations in cancerBreast Implant and ReconstructionWomen's cancer prevention and management

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Prophylactic Mastectomy in BRCA1/2 Mutation Carriers and Women at Risk of Hereditary Breast Cancer: Long-Term Experiences at the Rotterdam Family Cancer Clinic

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Heemskerk-Gerritsen, Bernadette A. M., Brekelmans, Cecile T. M., Menke-Pluymers, Marian B. E., van Geel, Albert N., Tilanus-Linthorst, Madeleine M. A., Bartels, Carina C. M., Tan, Murly, Meijers-Heijboer, Hanne E. J., Klijn, Jan G. M., Seynaeve, Caroline·2007·Annals of Surgical Oncology

DOI 10.1245/s10434-007-9449-xPMC PMC2077910

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Abstract

BACKGROUND: BRCA1/2 mutation carriers and women from a hereditary breast(/ovarian) cancer family have a highly increased risk of developing breast cancer (BC). Prophylactic mastectomy (PM) results in the greatest BC risk reduction. Long-term data on the efficacy and sequels of PM are scarce. METHODS: From 358 high-risk women (including 236 BRCA1/2 carriers) undergoing PM between 1994 and 2004, relevant data on the occurrence of BC in relation to PM, complications in relation to breast reconstruction (BR), mutation status, age at PM and preoperative imaging examination results were extracted from the medical records, and analyzed separately for women without (unaffected, n = 177) and with a BC history (affected, n = 181). RESULTS: No primary BCs occurred after PM (median follow-up 4.5 years). In one previously unaffected woman, metastatic BC was detected almost 4 years after PM (primary BC not found). Median age at PM was younger in unaffected women (P < .001), affected women more frequently were 50% risk carriers (P < .001). Unexpected (pre)malignant changes at PM were found in 3% of the patients (in 5 affected, and 5 unaffected women, respectively). In 49.6% of the women opting for BR one or more complications were registered, totaling 215 complications, leading to 153 surgical interventions (71%). Complications were mainly related to cosmetic outcome (36%) and capsular formation (24%). CONCLUSIONS: The risk of developing a primary BC after PM remains low after longer follow-up. Preoperative imaging and careful histological examination is warranted because of potential unexpected (pre)malignant findings. The high complication rate after breast reconstruction mainly concerns cosmetic issues.

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Authors: Heemskerk-Gerritsen, B. A. M., Brekelmans, C. T. M., Menke-Pluymers, M. B. E., van Geel, A. N., Tilanus-Linthorst, M. M. A., Bartels, C. C. M., Tan, M., Meijers-Heijboer, H. E. J., Klijn, J. G. M., & Seynaeve, C.
Affiliations: Erasmus MC Cancer Institute (NL)
Corresponding author: Seynaeve, Caroline
ORCID: Meijers-Heijboer, Hanne E. J.
Venue: Annals of Surgical Oncology
Publisher: Springer Science and Business Media LLC
Published: 2007-05-31
Volume: 14
Issue: 12
Pages: 3335-3344
ISSN: 1068-9265 (ISSN-L)
1534-4681
DOI: 10.1245/s10434-007-9449-x
PMC: PMC2077910
OpenAlex: W2108830626
Cited by: 153
References: 38
Citations by year: 2026: 3 · 2025: 3 · 2024: 4 · 2023: 10 · 2022: 7 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 11 · 2015: 9 · 2014: 14 · 2013: 14 · 2012: 6
FWCI: 5.89
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: Annals of Surgical Oncology (publishedVersion, cc-by-nc)
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Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
Health Sciences › Medicine › Surgery › Breast Implant and Reconstruction
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords: prophylactic mastectomy, BRCA1 mutation carriers, BRCA2 mutation carriers, hereditary breast cancer, breast reconstruction complications, capsular contracture, cosmetic outcome, preoperative imaging, breast cancer risk reduction, high-risk women
MeSH terms: Adult, Breast Neoplasms, Female, Follow-Up Studies, Humans, Longitudinal Studies, Mastectomy, Middle Aged, Mutation, Neoplasm Staging, Netherlands, Ovarian Neoplasms, Postoperative Complications, Prospective Studies, Retrospective Studies, Risk Factors, Cohort Studies, Incidence, Mammaplasty, Treatment Outcome, Germ-Line Mutation, BRCA1 Protein, Genetic Predisposition to Disease, BRCA2 Protein

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Prophylactic Mastectomy in BRCA1/2 Mutation Carriers and Women at Risk of Hereditary Breast Cancer: Long-Term Experiences at the Rotterdam Family Cancer Clinic

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