Practice Patterns of Surgeons for the Management of Hereditary Breast Cancer in Korea

Abstract

. A total of 43 surgeons from 42 hospitals responded to the survey. Results: Of the respondents, 81.4% (n=35) asked for information related to the family histories of cancer and 58.1% (n=25) recommended genetic testing for their patients. Indications for genetic testing recommended by the 25 surgeons were the following: breast cancer patients with family histories of breast or ovarian cancer (96%), bilateral breast cancer (80%), early-onset (64%) or male breast cancer (52%), and a double primary malignancy with breast and ovarian cancer (36%). Of the respondents, 52% (13/25) performed genetic counseling before genetic testing, and the surgeons (81.3%, 13/16) or genetic counselors (18.7%, 3/16) provided the genetic counseling. Although 154 BRCA1/2 mutation carriers of 95 families have been identified so far, only 12 family members were managed for prophylaxis by tamoxifen chemoprevention (n=2), a contralateral prophylactic mastectomy (n=2) or a prophylactic oophorectomy (n=8). There was no report of a bilateral prophylactic mastectomy being performed. Conclusion: Although BRCA1/2 mutation carriers for highrisk patients with hereditary breast cancer have been identified in Korea, practice and management for cancer prevention does not seem to be actively performed. The Korean Hereditary Breast Cancer (KOHBRA) Study will serve to establish the Korean guidelines of evidence-based clinical practice for hereditary breast cancer.

Perceptions of Prophylactic Mastectomy in Korea

“…The first case of prophylactic mastectomy in Korea was a contralateral prophylactic mastectomy performed along with oophorectomy in 2008 [ 12 ]. However, prophylactic mastectomy is not routinely performed in Korea [ 13 ].…”

The Korean Hereditary Breast Cancer Study: Review and Future Perspectives

“…In 2007, before the first phase of the KOHBRA study, a nationwide survey of 43 healthcare providers was conducted to examine practice patterns for the management of HBOC [30]. Among the respondents, 81.4% ascertained family histories of cancer and 58.1% recommended BRCA1/2 genetic testing for their patients at risk for HBOC.…”

“…This finding suggested that most Korean women with BRCA mutations chose intensive surveillance for cancer prevention. In addition, previous nationwide surveys of the management patterns of HBOC in 2007 and 2009 revealed the low uptake of chemoprevention and RRS for breast and ovarian cancer prevention in Korea [30,31]. …”

Hereditary Breast Cancer in Korea

“…When genetic counseling was conducted, it was carried out by the brea st surgeons themselves (81%) or by nurses (19%). 69) We conducted a follow-up survey 2 years after the initiation of the KOHBRA study. According to the 2009 follow-up survey, most physicians (60.0%) tended to draw a pedigree, which was higher than that reported in the initial 2007 survey (48.0%).…”