J Breast Cancer.  2020 Dec;23(6):647-655. 10.4048/jbc.2020.23.e61.

Trends in Risk-Reducing Mastectomy and Risk-Reducing SalpingoOophorectomy in Korean Carriers of the BRCA1/2 Mutation

Affiliations
  • 1Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 3Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
  • 5Department of Surgery, National Cancer Center, Goyang, Korea
  • 6Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
  • 7Division of Breast Thyroid Surgery, Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
  • 8Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 9Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  • 10Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
  • 11Department of Surgery, Daerim St. Mary's Hospital, Seoul, Korea

Abstract

Purpose
BRCA1/2 mutations are associated with risks of breast and ovarian cancer. In Korea, incidences of BRCA1/2 genetic testing and risk-reducing surgery (RRS) have increased with insurance coverage and the Angelina Jolie effect. The aim of this study was to identify trends in RRS performed in Korean women with the BRCA1/2 mutation.
Methods
We retrospectively reviewed the medical records of BRCA1/2 mutation carriers with (affected carriers) and without (unaffected carriers) breast cancer until August 2018 from 25 Korean Hereditary Breast Cancer (KOHBRA)-affiliated hospitals.
Results
The numbers of contralateral risk-reducing mastectomy (RRM) and risk-reducing bilateral salpingo-oophorectomy (RRBSO) in affected carriers have increased 5.8- and 3.6-fold, respectively, since 2013. The numbers of RRBSO in unaffected carriers has increased 8-fold since 2013. The number of institutions that perform RRS has increased gradually. The number of hospitals that perform contralateral RRM on affected carriers increased from 3 in 2012 to 11 in 2018, and that of those that perform RRBSO increased from 7 to 17. The number of hospitals that perform bilateral RRM on unaffected carriers increased from 1 in 2012 to 2 in 2018, and that of those that perform RRBSO increased from 1 to 8. However, the hospitals showed differences in the rates of RRM or RRBSO performed.
Conclusion
The incidence of RRS increased each year throughout the study period. However, in Korea, the rate of RRS procedures depended on the hospital.

Keyword

Breast neoplasms; Genes; BRCA1; Genes; BRCA2; Prophylactic mastectomy; Salpingo-oophorectomy
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