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Prophylactic Mastectomy

Ruth Heisey, June C Carroll
OBJECTIVE: To summarize the best evidence on strategies to identify and manage women with a family history of breast cancer. SOURCES OF INFORMATION: A PubMed search was conducted using the search terms breast cancer, guidelines, risk, family history, management, and magnetic resonance imaging screening from 2000 to 2016. Most evidence is level II. MAIN MESSAGE: Taking a good family history is essential when assessing breast cancer risk in order to identify women suitable for referral to a genetic counselor for possible genetic testing...
October 2016: Canadian Family Physician Médecin de Famille Canadien
J V Hegde, J Wang, A Kusske, S A McCloskey
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Achilleas Thoma, Manraj Nirmal Kaur, Forough Farrokhyar, Daniel Waltho, Carolyn Levis, Peter Lovrics, Charlie H Goldsmith
You are a new plastic surgeon in the community and you are referred a patient interested in breast reconstruction. The patient is a 35-year-old female school teacher who had a bilateral prophylactic mastectomy 2 years earlier, as she was a BRCA gene carrier. Since she is of a petite build with very little subcutaneous tissue or extra skin in the lower abdomen, you decide that she is not a suitable candidate for an abdomen-based autologous tissue reconstruction. You recommend the technique of tissue expansion and silicone gel implants...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Kalatu R Davies, Abenaa M Brewster, Isabelle Bedrosian, Patricia A Parker, Melissa A Crosby, Susan K Peterson, Yu Shen, Robert J Volk, Scott B Cantor
BACKGROUND: Family history of breast cancer is associated with an increased risk of contralateral breast cancer (CBC) even in the absence of mutations in the breast cancer susceptibility genes BRCA1/2. We compared quality-adjusted survival after contralateral prophylactic mastectomy (CPM) with surveillance only (no CPM) among women with breast cancer incorporating the degree of family history. METHODS: We created a microsimulation model for women with first-degree, second-degree, and no family history treated for a stage I, II, or III estrogen receptor (ER)-positive or ER-negative breast cancer at the ages of 40, 50, 60, and 70...
2016: Breast Cancer Research: BCR
Kandice K Ludwig, Joan Neuner, Annabelle Butler, Jennifer L Geurts, Amanda L Kong
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...
October 2016: American Journal of Surgery
Lotte E Elshof, Michael Schaapveld, Marjanka K Schmidt, Emiel J Rutgers, Flora E van Leeuwen, Jelle Wesseling
PURPOSE: To assess the effect of different treatment strategies on the risk of subsequent invasive breast cancer (IBC) in women diagnosed with ductal carcinoma in situ (DCIS). METHODS: Up to 15-year cumulative incidences of ipsilateral IBC (iIBC) and contralateral IBC (cIBC) were assessed among a population-based cohort of 10,090 women treated for DCIS in the Netherlands between 1989 and 2004. Multivariable Cox regression analyses were used to evaluate associations of treatment with iIBC risk...
October 2016: Breast Cancer Research and Treatment
Joanne Kotsopoulos, Tomasz Huzarski, Jacek Gronwald, Christian F Singer, Pal Moller, Henry T Lynch, Susan Armel, Beth Karlan, William D Foulkes, Susan L Neuhausen, Leigha Senter, Nadine Tung, Jeffrey N Weitzel, Andrea Eisen, Kelly Metcalfe, Charis Eng, Tuya Pal, Gareth Evans, Ping Sun, Jan Lubinski, Steven A Narod
BACKGROUND: Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. METHODS: Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n = 3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable)...
January 2017: Journal of the National Cancer Institute
Donato Casella, Claudio Calabrese, Lorenzo Orzalesi, Ilaria Gaggelli, Lorenzo Cecconi, Caterina Santi, Roberto Murgo, Stefano Rinaldi, Lea Regolo, Claudio Amanti, Manuela Roncella, Margherita Serra, Graziano Meneghini, Massimiliano Bortolini, Vittorio Altomare, Carlo Cabula, Francesca Catalano, Alfredo Cirilli, Francesco Caruso, Maria Grazia Lazzaretti, Icro Meattini, Lorenzo Livi, Luigi Cataliotti, Marco Bernini
BACKGROUND: Reconstruction options following nipple-sparing mastectomy (NSM) are diverse and not yet investigated with level IA evidence. The analysis of surgical and oncological outcomes of NSM from the Italian National Registry shows its safety and wide acceptance both for prophylactic and therapeutic cases. A further in-depth analysis of the reconstructive approaches with their trend over time and their failures is the aim of this study. METHODS: Data extraction from the National Database was performed restricting cases to the 2009-2014 period...
September 6, 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
Cecilia W Huo, Dexing Huang, Grace L Chew, Prue Hill, Ambika Vohora, Wendy V Ingman, Danielle J Glynn, Nathan Godde, Michael A Henderson, Erik W Thompson, Kara L Britt
Women with high mammographic density (MD) are at increased risk of breast cancer (BC) after adjustment for age and body mass index. We have developed a murine biochamber model in which both high MD (HMD) and low MD (LMD) tissue can be propagated. Here, we tested whether cells isolated by collagenase digestion and fluorescence-activated cell sorting (FACS) from normal breast can be reconstituted in our biochamber model, which would allow cell-specific manipulations to be tested. Fresh breast tissue was collected from women (n = 7) undergoing prophylactic mastectomy...
November 2016: Cell Biology International
Anita Mamtani, Monica Morrow
Breast-conserving therapy (BCT) and mastectomy result in equivalent longterm survival. Locoregional recurrence rates after BCT have decreased over time and are now similar to those after mastectomy. Contralateral breast cancer rates are declining as well owing to the widespread use of adjuvant systemic therapy. Despite these improved outcomes, increasing rates of bilateral mastectomy for unilateral cancer have been observed in the United States. Medical indications for mastectomy are well defined and present in a minority of patients, and women at increased risk for contralateral cancer are a small proportion of the breast cancer population...
August 26, 2016: Annual Review of Medicine
Michael S Sabel, Casey T Kraft, Kent A Griffith, Jessica M Bensenhaver, Lisa A Newman, Sarah T Hawley, Adeyiza O Momoh
There has been an increasing use of bilateral mastectomy (BM) for breast cancer. We sought to examine our trends among breast conservation (BCT) candidates and women recommended for unilateral mastectomy (UM). Our prospective breast cancer database was queried for women with a first-time, unilateral breast cancer. Patient and histologic factors and surgical treatment, including reconstruction, were evaluated. A detailed chart review was performed among patients from two representative time periods as to the reasons the patient underwent mastectomy...
August 26, 2016: Breast Journal
Tina J Hieken, Judy C Boughey
No abstract text is available yet for this article.
August 2016: Gland Surgery
Jonathan Walter Esclovon, Melissa Ponder, Nail Aydin, Subhasis Misra
A 59-year-old woman with right breast mass was diagnosed with invasive ductal carcinoma (IDC). Workup consisted of bilateral diagnostic mammogram and ultrasound (US); both showed a right breast mass with normal left breast. Core biopsy showed IDC with estrogen receptor negative (ER-)/progesterone receptor negative (PR-) and HER2/neu positive receptor status. The patient underwent carboplatin-based chemotherapy with Herceptin. The mass completely resolved. The patient desired to proceed with bilateral total mastectomy with right sentinel lymph node biopsy (SLNB)...
August 18, 2016: BMJ Case Reports
Frederick Wang, Robin Chin, Merisa Piper, Laura Esserman, Hani Sbitany
BACKGROUND: Approximately 50,000 women per year in the United States undergo mastectomy and immediate prosthetic breast reconstruction, and most will receive prolonged prophylactic antibiotics. The effect of this practice on the risk of surgical site infections (SSIs) remains unclear. METHODS: We searched the Medline, Embase, and Cochrane Library databases for studies that compared <24 hours and >24 hours of antibiotics in cases of immediate prosthetic breast reconstruction...
August 15, 2016: Plastic and Reconstructive Surgery
Stephanie Tesson, Imogen Richards, David Porter, Kelly-Anne Phillips, Nicole Rankin, Toni Musiello, Michelle Marven, Phyllis Butow
OBJECTIVE: Most women diagnosed with unilateral breast cancer without BRCA1 or BRCA2 mutations are at low risk of contralateral breast cancer. Contralateral Prophylactic Mastectomy (CPM) decreases the relative risk of contralateral breast cancer, but may not increase life expectancy; yet international uptake is increasing. This study applied protection motivation theory (PMT) to determine factors associated with women's intentions to undergo CPM. METHODS: Three hundred eighty-eight women previously diagnosed with unilateral breast cancer and of negative or unknown BRCA1 or BRCA2 status were recruited from an advocacy group's research database...
May 2016: Patient Education and Counseling
Frederick L Moffat, Danny Yakoub
The purpose of this study is to assess the consequences for breast cancer patients of the trend away from breast conservation in favor of bilateral and contralateral mastectomy. The methods are followed from the review of the literature from 1991 to 2015. Breast-conserving surgery and sentinel lymph node biopsy, introduced into mainstream practice in the 1980s and 1990s, respectively, are now the standard of care for early-stage breast cancer. Disruptive change has unexpectedly supervened in the guise of bilateral mastectomy for cancer or prophylaxis and contralateral prophylactic mastectomy...
August 2016: Breast Cancer Research and Treatment
Judy C Boughey, Deanna J Attai, Steven L Chen, Hiram S Cody, Jill R Dietz, Sheldon M Feldman, Caprice C Greenberg, Rena B Kass, Jeffrey Landercasper, Valerie Lemaine, Fiona MacNeill, Julie A Margenthaler, David H Song, Alicia C Staley, Lee G Wilke, Shawna C Willey, Katharine A Yao
No abstract text is available yet for this article.
October 2016: Annals of Surgical Oncology
Judy C Boughey, Deanna J Attai, Steven L Chen, Hiram S Cody, Jill R Dietz, Sheldon M Feldman, Caprice C Greenberg, Rena B Kass, Jeffrey Landercasper, Valerie Lemaine, Fiona MacNeill, David H Song, Alicia C Staley, Lee G Wilke, Shawna C Willey, Katharine A Yao, Julie A Margenthaler
No abstract text is available yet for this article.
October 2016: Annals of Surgical Oncology
Maria K Venetis, Erina L MacGeorge, Dadrie F Baptiste, Ashton Mouton, Lorin B Friley, Rebekah Pastor, Kristen Hatten, Janaka Lagoo, Monet W Bowling, Susan E Clare
OBJECTIVES: The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. METHODS: Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013...
July 26, 2016: American Journal of Clinical Oncology
J R Benson, Z E Winters
No abstract text is available yet for this article.
September 2016: British Journal of Surgery
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