Society Of Surgical Oncology Breast Disease Site Working Group statement on bilateral risk-reducing mastectomy: Indications, outcomes, and risks Review
| Authors: | Singh, P.; Agnese, D. M.; Amin, M.; Barrio, A. V.; van den Bruele, A. B.; Burke, E. E.; Danforth, D. N. Jr; Dirbas, F. M.; Eladoumikdachi, F.; Fayanju, O. M.; Kantor, O.; Kumar, S.; Lee, M. C.; Matsen, C.; Nguyen, T. T.; Ozmen, T.; Park, K. U.; Plichta, J. K.; Reyna, C.; Showalter, S. L.; Styblo, T.; Tranakas, N.; Weiss, A.; Woodfin, A.; Laronga, C.; Boughey, J. C. |
| Review Title: | Society Of Surgical Oncology Breast Disease Site Working Group statement on bilateral risk-reducing mastectomy: Indications, outcomes, and risks |
| Abstract: | Bilateral risk-reducing mastectomy (BRRM) is the surgical removal of both breasts to reduce the risk of cancer. In this Society of Surgical Oncology position statement, we review the literature addressing the indications, outcomes, and risks of BRRM to update the society’s 2017 statement. We held a virtual meeting to outline key topics and conducted a literature search using PubMed to identify relevant articles. After literature review, recommendations were made according to group consensus. Individuals with a high lifetime risk of breast cancer due to pathogenic variants in high penetrance breast cancer–predisposition genes, early chest or breast radiation exposure, or a compelling family history should be counseled on the option of BRRM. However, BRRM is not recommended for most patients with high-risk lesions and may be contraindicated in patients who have other competing cancers and/or a high risk of surgical complications. BRRM effectively reduces the risk of breast cancer development, although the survival benefit is unclear. For patients with low-to-moderate breast cancer risk, alternative management strategies should be encouraged, including lifestyle modifications, high-risk screening, and risk-reducing medications. Discussions of BRRM should cover: (1) breast-cancer risk estimates; (2) the procedure’s degree of risk reduction and impact on survival; (3) surgical techniques, potential surgical complications and long-term sequelae; and (4) alternatives to surgery. Surgeons should encourage shared and informed decision making with patients who have an elevated lifetime risk of developing breast cancer. © Society of Surgical Oncology 2024. |
| Keywords: | cancer survival; surgical technique; review; cancer risk; risk benefit analysis; lymph node dissection; sentinel lymph node; treatment indication; cancer susceptibility; breast cancer; mastectomy; aromatase inhibitor; genetic variability; risk factors; cancer screening; pathology; breast neoplasms; risk factor; high risk patient; radiation exposure; postoperative complication; societies, medical; family history; breast tumor; surgical risk; medical society; tamoxifen; surgery; lifestyle modification; risk reduction; treatment contraindication; tumor gene; nipple-sparing mastectomy; risk reduction behavior; lobular carcinoma in situ; penetrance; raloxifene; breast hyperplasia; breast magnetic resonance imaging; occult cancer; adverse event; prophylactic mastectomy; shared decision making; digital mammography; patient-reported outcome; surgical oncology; high-risk lesion; lifetime risk; humans; prognosis; human; female; high-risk screening; contrast enhanced mammography; bilateral risk-reducing mastectomy; breast cancer-predisposition gene; risk-reducing medication |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 32 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2025-02-01 |
| Start Page: | 899 |
| End Page: | 911 |
| Language: | English |
| DOI: | 10.1245/s10434-024-16484-2 |
| PUBMED: | 39538100 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Source: Scopus |
