caa a22 4500 445333758 CHVBK 20180317142746.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1642-2 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1642-2 Preoperative Risk Assessment Among Women Undergoing Bilateral Prophylactic Mastectomy for Cancer Risk Reduction [Elektronische Daten] [Natasha Rueth, Melissa McMahon, Amanda Arrington, Karen Swenson, Joseph Leach, Todd Tuttle] Background: Cancer risk assessment is an important decision-making tool for women considering irreversible risk-reducing surgery. Our objective was to determine the prevalence of BRCA testing among women undergoing bilateral prophylactic mastectomy (BPM) and to review the characteristics of women who choose BPM within a metropolitan setting. Methods: We retrospectively reviewed records of women who underwent BPM in the absence of cancer within 2 health care systems that included 5 metropolitan hospitals. Women with invasive carcinoma or ductal carcinoma in situ (DCIS) were excluded; neither lobular carcinoma in situ (LCIS) nor atypical hyperplasia (AH) were exclusion criteria. We collected demographic information and preoperative screening and risk assessment, BRCA testing, reconstruction, and associated cancer risk-reducing surgery data. We compared women who underwent BRCA testing to those not tested. Results: From January 2002 to July 2009, a total of 71 BPMs were performed. Only 25 women (35.2%) had preoperative BRCA testing; 88% had a BRCA mutation. Compared with tested women, BRCA nontested women were significantly older (39.1 vs. 49.2years, P<0.001), had significantly more preoperative biopsies and mammograms and had fewer previous or simultaneous cancer risk-reducing surgery (oophorectomy). Among BRCA nontested women, common indications for BPM were family history of breast cancer (n=21, 45.6%) or LCIS or AH (n=16, 34.8%); 9 nontested women (19.6%) chose BPM based on exclusively on cancer-risk anxiety or personal preference. Conclusion: Most women who underwent BPM did not receive preoperative genetic testing. Further studies are needed to corroborate our findings in other geographic regions and practice settings. Society of Surgical Oncology, 2011 Rueth Natasha Department of Surgery, Division of Surgical Oncology, University of Minnesota, Minneapolis, MN, USA aut McMahon Melissa Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, MN, USA aut Arrington Amanda Department of Surgery, Division of Surgical Oncology, University of Minnesota, Minneapolis, MN, USA aut Swenson Karen Park Nicollet Health Services, Minneapolis, MN, USA aut Leach Joseph Park Nicollet Health Services, Minneapolis, MN, USA aut Tuttle Todd Department of Surgery, Division of Surgical Oncology, University of Minnesota, Minneapolis, MN, USA aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2515-2520 1068-9265 18:9<2515 2011 18 10434 https://doi.org/10.1245/s10434-011-1642-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1642-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rueth Natasha Department of Surgery, Division of Surgical Oncology, University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- McMahon Melissa Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Arrington Amanda Department of Surgery, Division of Surgical Oncology, University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Swenson Karen Park Nicollet Health Services, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Leach Joseph Park Nicollet Health Services, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Tuttle Todd Department of Surgery, Division of Surgical Oncology, University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2515-2520 1068-9265 18:9<2515 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer