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Time trends in uptake rates of risk-reducing mastectomy in Israeli asymptomatic BRCA1 and BRCA2 mutation carriers

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Abstract

Background

The rate of risk-reducing bilateral mastectomy (RRBM) among cancer-free Israeli female BRCA1/BRCA2 mutation carriers was reportedly 13% in 2010. Current RRBM rates in Israel and factors seemingly associated with opting for RRBM were reevaluated.

Methods

Israeli female cancer-free BRCA1/BRCA2 mutation carriers, who were followed at the high-risk clinic at Sheba Medical Center between January 2011 and April 2020 were eligible. Univariate Cox regression and log-rank test were used to study the crude association between potential predictors and performance of RRBM.

Results

Overall, 427 cancer-free BRCA1 (n = 218) or BRCA2 (n = 209) mutation carriers were included. Median age at genotyping was 33.6 years (interquartile range 26.8–41.8 years), median follow-up 4.4 years (range 0.1–7.6 years). Overall, 41/427 (9.6%) participants underwent RRBM, all of them within 5 years of genotyping. Being married (HR-2.57, p = 0.017) and having a first degree relative with breast cancer (BC) (HR-2.19, p = 0.017) were positively associated with RRBM, whereas any previous benign breast biopsy was negatively associated (HR-0.48, p = 0.029) with performing RRBM.

Conclusions

RRBM is still infrequently elected by Israeli BRCA1/BRCA2 mutation carriers, with married women with one relative with BC who have not undergone previous breast biopsy more likely to opt for RRBM.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

Statistical analysis was done by Ziv-Bar company, 20 Haazmon st, Holon, Israel. The authors did not have any writing assistance.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Lee Galmor and Rinat Bernstein-Molho have equally contributed to this study.

Authors and Affiliations

  1. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Lee Galmor, Rinat Bernstein-Molho, Miri Sklair-Levy & Eitan Friedman

  2. Breast Cancer Unit, Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Rinat Bernstein-Molho

  3. The Meirav High-Risk Clinic-Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Miri Sklair-Levy, Dana Madoursky-Feldman, Dov Zippel & Eitan Friedman

  4. Oncogenetics Unit, Institute of Genetics, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel

    Yael Laitman & Eitan Friedman

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  1. Lee Galmor
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  2. Rinat Bernstein-Molho
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  3. Miri Sklair-Levy
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Contributions

Conceptualization: RB-M, EF, DMF; methodology: LG; YL, DZ, MSL; formal analysis and investigation: LG; writing—original draft preparation: LG, RB-M; writing—review and editing: all authors; supervision: RB-M, EF.

Corresponding author

Correspondence to Eitan Friedman.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This work was performed as a part of the requirements for the MD degree from the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (L.G.).

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Galmor, L., Bernstein-Molho, R., Sklair-Levy, M. et al. Time trends in uptake rates of risk-reducing mastectomy in Israeli asymptomatic BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat 185, 391–399 (2021). https://doi.org/10.1007/s10549-020-05949-z

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