Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Breast Cancer Unit, Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Breast Cancer Res Treat. 2021 Jan;185(2):391-399. doi: 10.1007/s10549-020-05949-z. Epub 2020 Sep 30.
The rate of risk-reducing bilateral mastectomy (RRBM) among cancer-free Israeli female BRCA1/BRCA2 mutation carriers was reportedly 13% in 2010. Current RRBM rates in Israel and factors seemingly associated with opting for RRBM were reevaluated.
Israeli female cancer-free BRCA1/BRCA2 mutation carriers, who were followed at the high-risk clinic at Sheba Medical Center between January 2011 and April 2020 were eligible. Univariate Cox regression and log-rank test were used to study the crude association between potential predictors and performance of RRBM.
Overall, 427 cancer-free BRCA1 (n = 218) or BRCA2 (n = 209) mutation carriers were included. Median age at genotyping was 33.6 years (interquartile range 26.8-41.8 years), median follow-up 4.4 years (range 0.1-7.6 years). Overall, 41/427 (9.6%) participants underwent RRBM, all of them within 5 years of genotyping. Being married (HR-2.57, p = 0.017) and having a first degree relative with breast cancer (BC) (HR-2.19, p = 0.017) were positively associated with RRBM, whereas any previous benign breast biopsy was negatively associated (HR-0.48, p = 0.029) with performing RRBM.
RRBM is still infrequently elected by Israeli BRCA1/BRCA2 mutation carriers, with married women with one relative with BC who have not undergone previous breast biopsy more likely to opt for RRBM.
2010 年，无癌以色列女性 BRCA1/BRCA2 突变携带者接受降低风险双侧乳房切除术（RRBM）的比例据报道为 13%。本研究重新评估了目前以色列的 RRBM 率和选择 RRBM 的相关因素。
本研究纳入了 2011 年 1 月至 2020 年 4 月期间在谢巴医疗中心高危诊所接受随访的无癌 BRCA1/BRCA2 突变携带者。采用单因素 Cox 回归和对数秩检验来研究潜在预测因素与 RRBM 实施之间的粗关联。
共纳入 427 名无癌 BRCA1（n=218）或 BRCA2（n=209）突变携带者。基因分型时的中位年龄为 33.6 岁（四分位间距 26.8-41.8 岁），中位随访时间为 4.4 年（范围 0.1-7.6 年）。总体而言，41/427（9.6%）名参与者接受了 RRBM，均在基因分型后 5 年内进行。已婚（HR-2.57，p=0.017）和一级亲属有乳腺癌（BC）病史（HR-2.19，p=0.017）与 RRBM 呈正相关，而有任何既往良性乳腺活检史与 RRBM 呈负相关（HR-0.48，p=0.029）。
以色列 BRCA1/BRCA2 突变携带者选择 RRBM 的情况仍较少见，已婚、有一级亲属 BC 病史且无既往乳腺活检史的女性更有可能选择 RRBM。
