Prophylactic mastectomies and bilateral salpingo-oophorectomies in patients with breast cancer and BRCA mutation: an Austrian registry

Abstract

Abstract Objectives Risk-reducing surgeries are common in patients with breast cancer gene (BRCA) mutations. Certain patients develop breast cancer before they opt for these surgeries. We examined the frequency of risk-reducing mastectomies and salpingo-oophorectomy among Austrian patients with breast cancer and BRCA mutations. Methods In 2014, we established an Austrian registry of BRCA1 and BRCA2 mutation carriers. From onset until 2018, 111 patients were recruited from four breast cancer centers. Data on the type of mastectomy, reconstructions, and complications were collected. Results A small proportion of patients (13.5%) had bilateral breast cancer. Among patients with unilateral breast cancer, the majority (86.8%) opted for prophylactic mastectomy on the contralateral side. Those who underwent modified radical mastectomy were more likely to choose prophylactic surgery (p = 0.001). A total of 19.4% of patients experienced cancer relapse postoperatively. Immediate reconstructions were recorded (71.3%). In addition, patients undergoing immediate reconstruction were more likely to undergo a prophylactic operation on the contralateral side than those with delayed reconstruction (p = 0.001). A mesh was used in only 47.8% of all reconstructions. The subpectoral implant position was present in 75.6% of patients and the pre-pectoral position in 13.3%. A mesh was inserted in all patients with a the pre-pectoral implant position. Conclusion The results indicate that the patients understood the procedures considering their willingness for risk-reducing surgeries and the expectation of good cosmetic outcomes in immediate reconstructions.