Evans D G R, Lalloo F, Hopwood P, Maurice A, Baildam A, Brain A, Barr L, Howell A
Academic Unit of Medical Genetics and Regional Genetics Service, St Mary's Hospital, Hathersage Road, Manchester, UK.
Eur J Surg Oncol. 2005 Dec;31(10):1112-8. doi: 10.1016/j.ejso.2005.05.007. Epub 2005 Jul 7.
To establish the uptake of contralateral risk reducing mastectomy in women informed of their risks and options at time of diagnosis of their primary unilateral breast cancer.
We have assessed the surgical choices of 70 women diagnosed with breast cancer <50 years as part of a family history surveillance program and fully informed about their contralateral risks and surgical options. We have compared this to women from other surgical clinics who were subsequently found to harbour a pathogenic BRCA1/2 mutation.
Sixty-five percent (13/20) of BRCA1/2 mutation carriers and 59% (n=20/34) of those at the highest level of risk pre-diagnosis (33+% lifetime risk) opted for contra-lateral mastectomy in the study sample. In contrast only 10% (n=9/88) women identified as mutation carriers from other clinics opted for such surgery.
We would suggest that women with a significant family history and therefore a high contra-lateral breast cancer risk, should have these risks and management options discussed at the time of diagnosis of breast cancer.
确定在原发性单侧乳腺癌诊断时被告知其风险和选择的女性中对侧预防性乳房切除术的接受情况。
作为家族病史监测项目的一部分，我们评估了70例诊断为乳腺癌的50岁以下女性的手术选择，并充分告知她们对侧乳房的风险和手术选择。我们将其与其他外科诊所中后来被发现携带致病性BRCA1/2突变的女性进行了比较。
在研究样本中，65%（13/20）的BRCA1/2突变携带者和59%（n=20/34）诊断前处于最高风险水平（终生风险33%以上）的女性选择了对侧乳房切除术。相比之下，在其他诊所被确定为突变携带者的女性中，只有10%（n=9/88）选择了这种手术。
我们建议，有显著家族病史且因此对侧乳腺癌风险较高的女性，应在乳腺癌诊断时讨论这些风险和管理选择。
