The frequency and outcome of breast cancer risk-reducing surgery in finnish <i>BRCA1</i> and <i>BRCA2</i> mutation carriers

Koskenvuo, Laura; Svarvar, Catarina; Suominen, Sinikka; Aittomäki, Kristiina; Jahkola, Tiina

doi:10.1177/1457496913490460

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Complication rates after reconstruction vary considerably in the literature, from 8% to 64% 108. The most common complication is early wound necrosis/epidermolysis usually involving the NAC or skin edges, sometimes leading to implant loss 109.…”

Section: Prophylactic Surgerymentioning

confidence: 99%

Hereditary lobular breast cancer with an emphasis on E-cadherin genetic defect

et al. 2018

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Recent studies have reported germline mutations in cases of lobular breast cancer (LBC) not associated with the classical hereditary diffuse gastric cancer syndrome. A multidisciplinary workgroup discussed genetic susceptibility, pathophysiology and clinical management of hereditary LBC (HLBC). The team has established the clinical criteria for screening and results' interpretation, and created consensus guidelines regarding genetic counselling, breast surveillance and imaging techniques, clinicopathological findings, psychological and decisional support, as well as prophylactic surgery and plastic reconstruction. Based on a review of current evidence for the identification of HLBC cases/families, genetic testing is recommended in patients fulfilling the following criteria: (A) bilateral LBC with or without family history of LBC, with age at onset<50 years, and (B) unilateral LBC with family history of LBC, with age at onset <45 years. In asymptomatic mutant carriers, breast surveillance with clinical examination, yearly mammography, contrast-enhanced breast MRI and breast ultrasonography (US) with 6-month interval between the US and the MRI should be implemented as a first approach. In selected cases with personal history, family history of LBC and mutations, prophylactic mastectomy could be discussed with an integrative group of clinical experts. Psychodecisional support also plays a pivotal role in the management of individuals with or without germline alterations. Ultimately, the definition of a specific protocol for genetic screening and ongoing coordinated management of patients with HLBC is crucial for the effective surveillance and early detection of LBC.

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Section: Prophylactic Surgerymentioning

confidence: 99%

Hereditary lobular breast cancer with an emphasis on E-cadherin genetic defect

et al. 2018

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“…RRM should fulfil the goals of safety, retained body image, and health-related quality of life (HRQoL). Though bilateral RRM shows a risk-reduction of approximately 90% for developing breast cancer in asymptomatic individuals [1e4], the need for reoperations, due to postoperative complications and/or revisions to achieve satisfying cosmetic results after implant-based reconstruction, still exists [5,6].…”

Section: Introductionmentioning

confidence: 99%

Body image problems in women with and without breast cancer 6–20 years after bilateral risk-reducing surgery – A prospective follow-up study

et al. 2019

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To prospectively follow-up and investigate women's perceptions of the cosmetic outcome of their implant-based breast reconstruction, body image, sexuality, anxiety/depressive symptoms, and health-related quality of life (HRQoL) 6e20 years after bilateral risk-reducing mastectomy (RRM), or complementary RRM after breast cancer diagnosis, due to increased risk of hereditary breast cancer. Patients and methods: Women with and without previous breast cancer diagnosis that underwent RRM between March 1997 and September 2010 were invited (n ¼ 200). We compared 146 (73%) sets of longterm questionnaire responses (e.g., EORTC QLQ-BRR26, Body Image Scale, Sexuality Activity Questionnaire, Hospital Anxiety and Depression Scale, and SF-36) with responses one year after surgery. Women with and without previous breast cancer were compared at the long-term assessment point. Results: The HRQoL and anxiety/depressive symptoms remained unchanged compared with one year after surgery, and there were no between-group differences. The negative impact on body image persisted in both groups for most of the items. 'Sexual discomfort' increased significantly for women with previous breast cancer (p ¼ 0.016). Women with previous breast cancer also reported more problems with 'Disease treatment/surgery related symptoms' (p ¼ 0.006) and 'Sexuality' (p ¼ 0.031) in the EORTC QLQ-BRR26 questionnaire. Conclusion: Problems with body image appeared to persist long time post-RRM. No differences in HRQoL were found at the long-term follow-up between women with and without previous breast cancer. The results of this investigation might be of use in improving future counselling before risk-reducing surgery for women in the decision-making process.

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“…The differences in the long term with both options (implants or autologous tissues) are not significant [83]. The complication rates after reconstruction vary considerably, 8-64% in the literature [84]. This may depend on patient selection or the definition of complications.…”

Section: Autologous Tissue Reconstructionmentioning

confidence: 99%

Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

et al. 2020

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Multiple synchronous (multifocal or multicentric) ipsilateral breast cancers with heterogeneous histopathology are a rare clinical occurrence, however, their incidence is increasing due to the use of MRI for breast cancer screening and staging. Some studies have demonstrated poorer clinical outcomes for this pattern of breast cancer, but there is no evidence to guide clinical practice. In this multidisciplinary review, we reflect on pathology and molecular characteristics, imaging findings, surgical management including conservation and reconstructive options and approach to the axilla, and the role of chemotherapy and radiotherapy. Multidisciplinary discussions appear decisive in planning an appropriate surgical choice and defining the correct systemic treatment tailored to each clinical condition.

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The frequency and outcome of breast cancer risk-reducing surgery in finnish BRCA1 and BRCA2 mutation carriers

Cited by 6 publications

References 33 publications

Hereditary lobular breast cancer with an emphasis on E-cadherin genetic defect

Hereditary lobular breast cancer with an emphasis on E-cadherin genetic defect

Body image problems in women with and without breast cancer 6–20 years after bilateral risk-reducing surgery – A prospective follow-up study

Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

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