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Medline ® Abstract for Reference 17

of 'Management of patients at high risk for breast and ovarian cancer'

Risk reduction and survival benefit of prophylactic surgery in BRCA mutation carriers, a systematic review.
Ludwig KK, Neuner J, Butler A, Geurts JL, Kong AL
Am J Surg. 2016;212(4):660. Epub 2016 Jul 18.
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 oflife.
Department of Surgery, Indiana University School of Medicine, Carmel, IN, USA.