Breast cancer in BRCA mutation carriers: breast-conserving therapy or bilateral mastectomy?

Author： Murphy James O Sacchini Virgilio S

ISSN： 2044-9038

Source： Clinical Practice, Vol.10, Iss.6, 2013-11, pp. : 751-764

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Abstract

SUMMARY BRCA mutation carriers who are diagnosed with breast cancer can be overwhelmed with decisions. The choice between breast-conserving therapy, mastectomy or a bilateral mastectomy is often the first to be made by patients. Those who choose breast-conserving therapy are faced with an increased risk of ipsilateral breast tumor recurrence and contralateral breast cancer; however, choosing more extensive surgery increases surgical morbidity without a proven survival advantage. Additional factors that influence surgical decision-making are the use of adjuvant therapy, the role of risk-reducing salpingo-oophorectomy and the biology of the breast cancer. Advances in surgical techniques, breast reconstruction and screening must also be considered when choosing the surgical treatment for breast cancer patients with a BRCA mutation.