Risk-reducing mastectomy and reconstruction following prophylactic breast irradiation: Hope sustained

Merav A. Ben David, Ella Evron, Adi F. Rasco, Ayelet Shai, Benjamin W. Corn

Research output: Contribution to journalArticlepeer-review

Abstract

Risk-reducing mastectomy (RRM) is often advocated for BRCA1/2 mutation carriers who face a heightened lifetime risk of breast cancer. However, many carrier patients seek alternative risk-reducing measures. In a phase II nonrandomized trial, we previously reported that prophylactic irradiation to the contralateral breast among BRCA carriers undergoing breast-conserving treatment significantly reduced subsequent contralateral breast cancer. Herein, we report the outcome of salvage mastectomy and reconstruction in 11 patients that suffered reoccurrences of breast cancer in either the ipsilateral or contralateral breast or elected to have the procedure for risk reduction during the eight-year follow-up period. Patients’ satisfaction with the procedure and physicians’ assessment of the cosmetic outcome were not inferior for previously irradiated compared to non-irradiated breasts. Although the numbers are small, the results are encouraging and sustain hope in a challenging population. Our findings support continuing research as well as a discussion of risk-reduction alternatives besides mastectomy, including prophylactic breast irradiation, in BRCA1/2 mutation carriers.

Original languageEnglish
Article number2694
JournalCancers
Volume13
Issue number11
DOIs
StatePublished - 1 Jun 2021

Keywords

  • BRCA mutation
  • Breast cancer
  • Prophylactic breast irradiation

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