Risk reduction and survival benefit of prophylactic surgery in BRCA mutation carriers, a systematic review

Kandice K. Ludwig, Joan Neuner, Annabelle Butler, Jennifer L. Geurts, Amanda L. Kong

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

Background Mutations in BRCA1 or BRCA2 genes results in an elevated risk for developing both breast and ovarian cancers over the lifetime of affected carriers. General surgeons may be faced with questions about surgical risk reduction and survival benefit of prophylactic surgery. Methods A systematic literature review was performed using the electronic databases PubMed, OVID MEDLINE, and Scopus comparing prophylactic surgery vs observation with respect to breast and ovarian cancer risk reduction and mortality in BRCA mutation carriers. Results Bilateral risk-reducing mastectomy provides a 90% to 95% risk reduction in BRCA mutation carriers, although the data do not demonstrate improved mortality. The reduction in ovarian and breast cancer risks using risk-reducing bilateral salpingo-oophorectomy has translated to improvement in survival. Conclusions Clinical management of patients at increased risk for breast cancer requires consideration of risk, patient preference, and quality of life.

Original languageEnglish (US)
Pages (from-to)660-669
Number of pages10
JournalAmerican Journal of Surgery
Volume212
Issue number4
DOIs
StatePublished - Oct 1 2016

Keywords

  • BRCA
  • Mastectomy
  • Oophorectomy
  • Prophylactic
  • Risk reducing

ASJC Scopus subject areas

  • Surgery

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