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Genetic Diagnosis before Surgery has an Impact on Surgical Decision in BRCA Mutation Carriers with Breast Cancer

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Abstract

Background

The first aim of our study was to evaluate surgical decision-making by BRCA mutation carriers with breast cancer based on the timing of knowledge of their BRCA mutation status. The second aim was to evaluate breast cancer outcome following surgical treatment.

Methods

This was a retrospective study of 164 patients diagnosed with invasive breast cancer, tested for BRCA mutation, and treated with primary surgery between 2004 and 2015 at Samsung Medical Center in Seoul, Korea. We reviewed types of surgery and timing of the BRCA test result. We compared surgical decision- making of BRCA carriers with breast cancer based on the timing of knowledge of their BRCA mutation status.

Results

Only 15 (9.1%) patients knew their BRCA test results before their surgery, and 149 (90.9%) knew the results after surgery. In patients with unilateral cancer, there was a significant difference between groups whose BRCA mutation status known before surgery and groups whose BRCA status unknown before surgery regarding the choice of surgery (p = 0.017). No significant difference was observed across surgery types of risk of ipsilateral breast tumor recurrence (p = 0.765) and contralateral breast cancer (p = 0.69).

Conclusion

Genetic diagnosis before surgery has an impact on surgical decision choosing unilateral mastectomy or bilateral mastectomy in BRCA mutation carriers with breast cancer. Knowledge about BRCA mutation status after initial surgery led to additional surgeries for patients with BCS. Thus, providing genetic counseling and genetic testing before surgical choice and developing treatment strategies for patients with a high risk of breast cancer are important.

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Acknowledgements

The study was approved by the Institutional Review Board of the Samsung Medical Center, Seoul, Korea (Approval Numbers: 2017-01-142).

Author information

Authors and Affiliations

  1. Department of Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea

    Sungmin Park

  2. Breast Division, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, Korea

    Jeong Eon Lee, Jai Min Ryu, Issac Kim, Se Kyung Lee, Jonghan Yu, Seok Won Kim & Seok Jin Nam

  3. Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea

    Soo Youn Bae

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  1. Sungmin Park
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Corresponding author

Correspondence to Jeong Eon Lee.

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The authors declare that they have no conflict of interest in this manuscript, including financial, consultant, institutional, or other relationships that might lead to bias.

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Park, S., Lee, J.E., Ryu, J.M. et al. Genetic Diagnosis before Surgery has an Impact on Surgical Decision in BRCA Mutation Carriers with Breast Cancer. World J Surg 42, 1384–1390 (2018). https://doi.org/10.1007/s00268-017-4342-7

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  • DOI: https://doi.org/10.1007/s00268-017-4342-7

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