1. Attitude of BRCA1/2 mutation carriers towards surgical risk reduction for breast, ovarian and uterine cancer: still much to be done.
- Author
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Nahshon C, Segev Y, Schmidt M, and Lavie O
- Subjects
- Humans, Female, Adult, Cross-Sectional Studies, Middle Aged, Uterine Neoplasms surgery, Uterine Neoplasms genetics, Salpingo-oophorectomy, BRCA1 Protein genetics, Heterozygote, Surveys and Questionnaires, BRCA2 Protein genetics, Aged, Genes, BRCA2, Genes, BRCA1, Genetic Predisposition to Disease, Young Adult, Ovarian Neoplasms genetics, Ovarian Neoplasms surgery, Ovarian Neoplasms prevention & control, Breast Neoplasms genetics, Breast Neoplasms surgery, Risk Reduction Behavior, Mutation
- Abstract
Objective: To study and quantify the attitude of BRCA1/2 mutation carriers towards surgical risk reduction procedures., Methods: This cross-sectional national study was conducted by distribution of an anonymous questionnaire on social media platforms and to BRCA1/2 carriers' medical clinic., Results: 530 BRCA1/2 mutation carriers answered the survey. Risk reduction bilateral salpingo-oophorectomy was discussed with 447/489 (91%) of patients and performed in 260/489 (53%). Hormonal replacement therapy was discussed in 280/474 (59%) of patients. Addition of hysterectomy to risk reduction bilateral salpingo-oophorectomy was discussed in 129/481 (27%) of patients and performed in 44/443(10%). Age over 35 years at time of mutation detection was found to be significant in raising risk reduction bilateral salpingo-oophorectomy and hysterectomy performance rates. Risk reduction mastectomy was discussed in 390/471 (83%) of patients and performed in 156/471 (33%). In a multivariate analysis, BRCA1 mutation carriers (OR=1.66 (95% CI 1.07 to 2.57), p=0.024) and a personal cancer history leading to the mutation detection (OR=4.75 (95% CI 1.82 to 12.4), p=0.001) were found to be significant in increasing the likelihood of opting for risk reduction mastectomy. Additionally, highest risk reduction mastectomy performance rates were observed in the group of patients with a first-degree family history of breast cancer under the age of 50 years (OR=1.58 (95% CI 1.07 to 2.32), p=0.01)., Conclusions: This study highlights the high performance rates of risk reduction bilateral salpingo-oophorectomy, while hysterectomy was added in 10%, and that despite high awareness and acceptance rates for risk reduction mastectomy, only 33% had the procedure. The data presented provides insights for the clinician counseling BRCA1/2 mutation carriers, with regards to adherence to recommendations, understanding their concerns towards treatment and management alternatives; and finally, to construct a personalized management medical plan., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2024
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