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Am J Surg. 2017 Oct;214(4):687-694. doi: 10.1016/j.amjsurg.2017.06.017. Epub 2017 Jun 28.

Patient experience with breast reconstruction process following bilateral mastectomy in BRCA mutation carriers.

Author information

1
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
2
Dana Farber Cancer Institute, Boston, MA, USA.
3
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
4
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Dana Farber Cancer Institute, Boston, MA, USA. Electronic address: ldominici@partners.org.

Abstract

BACKGROUND:

Many patients with BRCA mutations consider bilateral mastectomy for risk reduction (RRM) or when diagnosed with cancer (TM). Limited data exist to help inform patients about the reconstruction (recon) process. We sought to identify factors associated with unforeseen procedures following RRM or TM in BRCA positive patients.

METHODS:

We retrospectively evaluated records from 178 BRCA positive patients who had RRM or TM with recon from 1997 to 2013 in a single healthcare system. Univariate and multivariate logistic regression was used to assess factors associated with unexpected procedures.

RESULTS:

One hundred four patients had RRM, and 78 had TM. Median time to completion was 9.0 months (95% CI 7.2-10.8). Overall, 57.3% of patients had an unexpected procedure and 21.9% had a complication requiring surgery. Unexpected revisions were associated with increasing age and radiation (in TM).

CONCLUSIONS:

BRCA positive patients may have multiple revision surgeries. The likelihood of unexpected procedures increases with age. Future studies are needed to inform patients about the recon process.

KEYWORDS:

BRCA; Bilateral mastectomy; Reconstruction

PMID:
28683895
DOI:
10.1016/j.amjsurg.2017.06.017
[Indexed for MEDLINE]

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