Annals of Surgical Oncology

, Volume 21, Issue 11, pp 3466–3472

Predictors that Influence Contralateral Prophylactic Mastectomy Election Among Women with Ductal Carcinoma In Situ Who Were Evaluated for BRCA Genetic Testing

Authors

  • Nisreen Elsayegh
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
  • Henry M. Kuerer
    • Department of Surgical OncologyThe University of Texas MD Anderson Cancer Center
  • Heather Lin
    • Department of BiostatisticsThe University of Texas MD Anderson Cancer Center
  • Angelica M. Gutierrez Barrera
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
  • Michelle Jackson
    • Department of Clinical Cancer GeneticsThe University of Texas MD Anderson Cancer Center
  • Kimberly I. Muse
    • Department of Clinical Cancer GeneticsThe University of Texas MD Anderson Cancer Center
  • Jennifer K. Litton
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
  • Constance Albarracin
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
  • Aimaz Afrough
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
  • Gabriel N. Hortobagyi
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
    • Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center
    • Department of Clinical Cancer GeneticsThe University of Texas MD Anderson Cancer Center
Breast Oncology

DOI: 10.1245/s10434-014-3747-x

Cite this article as:
Elsayegh, N., Kuerer, H.M., Lin, H. et al. Ann Surg Oncol (2014) 21: 3466. doi:10.1245/s10434-014-3747-x

Abstract

Background

Patients with ductal carcinoma in situ (DCIS) are at increased risk for developing contralateral breast cancer (CBC). Consequently, more women with DCIS are electing to undergo contralateral prophylactic mastectomy (CPM). We evaluated factors associated with CPM in patients with DCIS who underwent genetic counseling for BRCA testing.

Methods

This retrospective study involved 165 women with DCIS referred for genetic counseling between 2003 and 2011. Patient characteristics were age, marital and educational status, tumor markers, nuclear grade, family history of breast cancer (BC) and ovarian cancer (OC), race, Ashkenazi Jewish ancestry, and BRCA results. Univariate and multivariate logistic regression analyses were used to determine predictive factors associated with CPM election.

Results

Of 165 patients, 44 (27 %) underwent CPM. Patients <45 years of age were more likely to elect CPM (p = 0.0098). A BRCA+ mutation was found in 17 patients (10.3 %), and BRCA+ women were more likely to elect CPM than BRCA or untested women (p = 0.0001). Patients who had a family history of OC (57.7 %) were more likely to choose CPM than those with no family history (p = 0.0004). Younger age, BRCA+, and an OC family history remained significant in the multivariate model (p < 0.008).

Conclusion

The CPM rate among patients with DCIS who undergo genetic counseling is high. Factors associated with increased likelihood of CPM among this group were age, BRCA+, and a family history of OC. Further studies are needed to evaluate patients’ perceptions of CBC risk and their role in the likelihood of CPM choice.

Copyright information

© Society of Surgical Oncology 2014