Abstract
Background
We studied the extent of BRCA1/2 genetic testing to help select the surgical approach for patients with breast cancer
in Japan remains unclear.
Patients and Methods
The study subjects were female patients with primary unilateral invasive breast cancer
considered as candidates for breast-conserving surgery who underwent preoperative
BRCA1/2 genetic testing. A retrospective analysis was performed on the results of BRCA1/2 genetic testing and surgical method selection using national registration data from
the Japanese Hereditary Breast and Ovarian Cancer Syndrome Consortium.
Results
Our study included 318 female patients. Among these patients, 23.7% of patients with
BRCA1/2 mutations and 61.8% of patients without these variants underwent breast-conserving
surgery (P < .01). Among the patients with BRCA1/2 mutations, those who chose breast-conserving surgery tended not to undergo risk-reducing
salpingo-oophorectomy (P < .05). Among the patients with BRCA1/2 mutations who underwent mastectomy for the affected side, 31.8% received contralateral
risk-reducing mastectomy. Patients diagnosed with breast cancer under the age of 50
years were more likely to have contralateral risk-reducing mastectomy than patients
over the age 50 years (P < .05).
Conclusions
Patients with BRCA1/2 mutations tend to choose mastectomy. However, it is speculated that the final surgical
method selection is made in consideration of not only the test results but also with
careful consideration of the patient, taking into account other factors including
individual values for risk-reducing surgeries and the age of breast cancer onset.
Keywords
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Article Info
Publication History
Published online: August 19, 2020
Accepted:
August 10,
2020
Received in revised form:
July 27,
2020
Received:
February 7,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.