caa a22 4500 445335319 CHVBK 20180317142752.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1381-9 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1381-9 Breast Cancer Surgery Trend Changes Since the Introduction of BRCA1/2 Mutation Screening: A Retrospective Cohort Analysis of 158 Mutation Carriers Treated at a Single Institution [Elektronische Daten] [Angela Mislowsky, Susan Domchek, Cecilia Stroede, Meredith Bergey, Seema Sonnad, Liza Wu, Julia Tchou] Background: Bilateral mastectomy in women diagnosed with unilateral breast cancer is on the rise in the USA. One contributing factor is increased awareness of contralateral breast cancer risk. Positive testing for deleterious mutation in BRCA1/2 is a concrete measure of this contributing factor. We hypothesize that breast cancer surgery trend change is temporally associated with the introduction of BRCA1/2 genetic testing around 1996. Methods: Our study cohort included 158 BRCA1 or BRCA2 mutation carriers diagnosed with unilateral breast cancer between 1963 and 2009. Mutation carriers with ovarian cancer or bilateral breast cancer were excluded. Breast surgery and breast reconstruction surgery trends were analyzed according to year of breast cancer diagnosis or when bilateral mastectomy was performed, respectively. Results: Surgery trends changed significantly over time. We observed a significant drop in the rate of unilateral mastectomy (P<0.001) after the period 1996-2000, and the rate of bilateral mastectomy appears to be on the rise, up to 30.3% between 2006 and 2009. Breast reconstruction trends also changed significantly over time, with a significant rise in the rate of free flap reconstruction to 58.8% between 2006 and 2009. Conclusions: Our results demonstrated a significant decrease in unilateral mastectomy with a rise in bilateral mastectomy after the period 1996-2000, a period which encompassed the year when genetic testing of the two BRCA1/2 genes became commercially available, hence supporting our hypothesis. Society of Surgical Oncology, 2010 Mislowsky Angela Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut Domchek Susan Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut Stroede Cecilia Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut Bergey Meredith Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut Sonnad Seema Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA aut Wu Liza Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA aut Tchou Julia Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 745-751 1068-9265 18:3<745 2011 18 10434 https://doi.org/10.1245/s10434-010-1381-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1381-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mislowsky Angela Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Domchek Susan Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Stroede Cecilia Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Bergey Meredith Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Sonnad Seema Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Wu Liza Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Tchou Julia Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 745-751 1068-9265 18:3<745 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer