Background BRCA1/2 mutation carriers and women from a hereditary breast(/ovarian) cancer family have a highly increased risk of developing
breast cancer (BC). Prophylactic mastectomy (PM) results in the greatest BC risk reduction. Long-term data on the efficacy
and sequels of PM are scarce.
Methods From 358 high-risk women (including 236 BRCA1/2 carriers) undergoing PM between 1994 and 2004, relevant data on the occurrence
of BC in relation to PM, complications in relation to breast reconstruction (BR), mutation status, age at PM and preoperative
imaging examination results were extracted from the medical records, and analyzed separately for women without (unaffected,
n = 177) and with a BC history (affected, n = 181).
Results No primary BCs occurred after PM (median follow-up 4.5 years). In one previously unaffected woman, metastatic BC was detected
almost 4 years after PM (primary BC not found). Median age at PM was younger in unaffected women (P < .001), affected women more frequently were 50% risk carriers (P < .001). Unexpected (pre)malignant changes at PM were found in 3% of the patients (in 5 affected, and 5 unaffected women,
respectively). In 49.6% of the women opting for BR one or more complications were registered, totaling 215 complications,
leading to 153 surgical interventions (71%). Complications were mainly related to cosmetic outcome (36%) and capsular formation
Conclusions The risk of developing a primary BC after PM remains low after longer follow-up. Preoperative imaging and careful histological
examination is warranted because of potential unexpected (pre)malignant findings. The high complication rate after breast
reconstruction mainly concerns cosmetic issues.
|Journal||Annals of Surgical Oncology|
|Publication status||Published - 2007|