Outcomes of Concurrent Breast and Gynecologic Risk Reduction Surgery

Abstract

Background

Women considering risk reduction surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated multispecialty surgery.

Methods

We conducted a retrospective review of patients undergoing simultaneous breast and gynecologic surgery for newly or previously diagnosed breast cancer and/or an inherited cancer gene mutation during the same anesthetic at a single institution from 1999 to 2013.

Results

Seventy-three patients with a mean age of 50 years (range 27–88) were identified. Most patients had newly diagnosed breast cancer or ductal carcinoma in situ (62 %) and 28 patients (38 %) had an identified BRCA mutation. Almost all gynecologic procedures were for risk reduction or benign gynecologic conditions (97 %). Mastectomy was performed in 39 patients (53 %), the majority of whom (79 %) underwent immediate reconstruction. The most common gynecologic procedure involved bilateral salpingo-oophorectomy, which was performed alone in 18 patients (25 %) and combined with hysterectomy in 40 patients (55 %). A total of 32 patients (44 %) developed postoperative complications, most of which were minor and did not require surgical intervention or hospitalization. Two of the 19 patients who underwent implant reconstruction (11 %; 3 % of the entire cohort) had major infectious complications requiring explantation.

Conclusion

Combined breast and gynecologic procedures for a breast cancer diagnosis and/or risk reduction in patients can be accomplished with acceptable morbidity. Concurrent operations, including reconstruction, can be offered to patients without negatively impacting their outcome.

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Correspondence to Barbara A. Pockaj MD.

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Ma, I.T., Gray, R.J., Wasif, N. et al. Outcomes of Concurrent Breast and Gynecologic Risk Reduction Surgery. Ann Surg Oncol 24, 77–83 (2017). https://doi.org/10.1245/s10434-016-5479-6

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Keywords

  • National Comprehensive Cancer Network
  • Breast Reconstruction
  • National Comprehensive Cancer Network
  • Gynecologic Surgery
  • Bilateral Mastectomy