Department of Breast Surgical Oncology, St. Luke'S International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
Breast Surgery Clinic, YCC Takanawa Bild., 2,3/F Takanawa, Minato-ku, Tokyo, 108-0074, Japan.
Breast Cancer. 2020 Jan;27(1):70-76. doi: 10.1007/s12282-019-00995-y. Epub 2019 Jul 10.
Breast reconstruction is a favorable option for women with BRCA1 or BRCA2 mutations (BRCA1/2) who undergo risk-reducing mastectomy (RRM). We assessed characteristics of patients who underwent RRM, with or without breast reconstruction.
We included 46 patients with BRCA1/2 who underwent RRM from July 2011 to December 2017.
Among the 46 patients who underwent RRM, 3 had not been diagnosed with breast cancer (BC) and 43 had cancer in a single breast; 33 patients (71.7%) underwent breast reconstruction with RRM; and 13 patients (28.3%) did not undergo breast reconstruction. All of 3 patients who had not been diagnosed with BC underwent bilateral RRM with breast reconstruction. There was no significant difference of clinical characteristic between patients undergoing RRM with and without breast reconstruction. However, patients who decided to undergo RRM with the current diagnosis of BC had significantly higher rates of RRM with breast reconstruction than that of patients with a past history of BC (P = 0.043). The rate of nipple-sparing mastectomy (NSM) in patients with breast reconstruction was significantly higher (28 of the 37 breasts, 75.7%) than that in patients without reconstruction (3 of the 14 breasts, 21.4%) (P < 0.001). Two patients who had complications underwent RRM with breast reconstruction, and one of them had a history of irradiation after lumpectomy.
For BRCA1/2 patients, the decision of taking RRM with the diagnosis of current BC might affect whether they undergo immediate breast reconstruction with RRM. These patients who undergo RRM with breast reconstruction preferred NSM to skin-sparing mastectomies.
对于接受降低风险乳房切除术（RRM）的 BRCA1 或 BRCA2 突变（BRCA1/2）的女性，乳房重建是一种有利的选择。我们评估了接受 RRM 且接受或未接受乳房重建的患者的特征。
我们纳入了 2011 年 7 月至 2017 年 12 月期间接受 RRM 的 46 名 BRCA1/2 患者。
在接受 RRM 的 46 名患者中，有 3 名患者未被诊断为乳腺癌（BC），43 名患者的单乳有癌症；33 名患者（71.7%）接受了 RRM 乳房重建；13 名患者（28.3%）未接受乳房重建。所有 3 名未被诊断为 BC 的患者均接受了双侧 RRM 乳房重建。接受 RRM 乳房重建的患者和未接受乳房重建的患者的临床特征无显著差异。然而，当前诊断为 BC 并决定接受 RRM 乳房重建的患者的 RRM 乳房重建率显著高于有既往 BC 病史的患者（P=0.043）。接受乳房重建的患者的保乳头乳房切除术（NSM）率明显更高（37 个乳房中的 28 个，75.7%），而未接受重建的患者（14 个乳房中的 3 个，21.4%）（P<0.001）。有 2 名患者出现并发症，均接受了 RRM 乳房重建，其中 1 名患者在接受保乳手术后接受了放疗。
对于 BRCA1/2 患者，当前诊断为 BC 并决定接受 RRM 可能会影响其是否接受 RRM 即刻乳房重建。这些接受 RRM 乳房重建的患者更倾向于 NSM 而不是皮肤保留乳房切除术。
