The Patient Demographic Details of Referrals for Risk Reducing Breast Surgery and Reconstruction to St Helen's and Knowsley Teaching Hospitals Over a 5 Year Period.
Published Date: 30th August 2023
Publication Authors:
Abstract
Breast cancer is the most common cause of cancer in women affecting 1 in 7 women in the UK. Hereditary breast cancers are present in up to 10% of all cases and are most commonly related to BRCA gene mutations. Bilateral risk reducing mastectomy (RRM) +/- reconstruction is the most effective strategy reducing breast cancer mortality risk. Reconstruction options can be classified into immediate vs delayed reconstruction and autologous vs alloplastic reconstruction. Complete reconstruction may take considerable time depending on waiting lists and may include additional aesthetic corrections such as lipomodelling and nipple reconstruction.
Method
Retrospective analysis of referrals (all ages) to a single surgeon at Whiston Hospital for breast reconstruction following RRM between 1/ 04/2015-1/04/2020.
Result
There were a total of 467 referrals. Of these, 76 (16%) were referred for breast reconstruction following RRM, 51 (67%) of these patients had confirmed genetic mutations and 24 (32%) had no genetic mutation. 48 (94%) patients were BRCA gene carriers of which 32 (63%) were BRCA2 carriers, 14 (27%) were BRCA1 carriers and 2 patients with unknown BRCA variants. There were 2 (4%) patients with CHEK2 mutations and 1 (2%) patient with Cowden's syndrome.
Conclusion
There is currently no standardised guidance on the timing of RRM and reconstruction in high-risk patients. The risk of breast cancer in high-risk patients increases with age, and there is need for a risk stratification tool for RRM and reconstruction waiting lists, to identify patients with the highest risk of breast cancer development considering their personal and family history.
Nelson, A; Taghizadeh, R. (2023). The Patient Demographic Details of Referrals for Risk Reducing Breast Surgery and Reconstruction to St Helen's and Knowssley Teaching Hospitals Over a 5 Year Period. British Journal of Surgery. 110(Suppl 7). [Online]. Available at: https://dx.doi.org/10.1093/bjs/z... [Accessed 5 January 2024].
« Back