Grinstein, Olga, Krug, Barbara, Hellmic, Martin, Siedek, Florian, Malter, Wolfram ORCID: 0000-0002-5693-3120, Burke, Christina, Schmutzler, Rita, Maintz, David and Rhiem, Kerstin (2019). Residual glandular tissue (RGT) in BRCA1/2 germline mutation carriers with unilateral and bilateral prophylactic mastectomies. Surg. Oncol.-Oxf., 29. S. 126 - 134. OXFORD: ELSEVIER SCI LTD. ISSN 1879-3320

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Abstract

Background: Prophylactic mastectomy (PME) is increasingly performed in women carrying deleterious BRCA1 and BRCA2 germline mutations. The oncologic risk resulting from residual fibroglandular tissue (RGT) is unknown. Methods: All women who had received a mastectomy and at least one postoperative breast MRI, between 2006 and 2016 were extracted from the register of the Center for Hereditary Breast and Ovarian Cancer Cologne (CHBOC). The index MRI was evaluated in terms of basic clinical data and the morphological criteria of RGT. The RGT volume was measured in diameter and was semi-automatically evaluated using software. Results: We identified 169 women carrying BRCA1/2 mutations who underwent prophylactic and curative mastectomy: a total of 338 breasts. RGT was found in 128 of the 338 breasts (37.9%). 68 of the 128 breasts (53.1%) were related to bilateral PME, 37 (28.9%) to unilateral PME and 23 (18.0%) to curative mastectomy. RGT was predominantly unifocal and located in the retroareolar breast region. RGT was observed more often after bilateral PME (p < 0.0001). In this subgroup, the nipple-sparing mastectomy dominated (108 of 136, 79.4%), in contrast to 23 standard mastectomies (23 of 94, 24.5%) in the subgroup of curative mastectomy (23%). There was a trend towards higher amounts of RGT in surgical units with fewer mastectomies performed. During follow-up, two breast cancers were detected after bilateral and unilateral PME, respectively. Conclusions: Our results suggest that the indication for surgery and in particular the selected surgical procedure affect the surgical outcome with respect to RGT. Oncological safety should not be neglected, especially in the high-risk group of BRCA1/2 mutation carriers.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Grinstein, OlgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krug, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellmic, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siedek, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Malter, WolframUNSPECIFIEDorcid.org/0000-0002-5693-3120UNSPECIFIED
Burke, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmutzler, RitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maintz, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rhiem, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-146677
DOI: 10.1016/j.suronc.2019.04.009
Journal or Publication Title: Surg. Oncol.-Oxf.
Volume: 29
Page Range: S. 126 - 134
Date: 2019
Publisher: ELSEVIER SCI LTD
Place of Publication: OXFORD
ISSN: 1879-3320
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
NIPPLE-SPARING MASTECTOMY; BREAST-CANCER; FAMILY-HISTORY; RISK; WOMEN; MRI; SURVEILLANCE; SOCIETY; OVARIANMultiple languages
Oncology; SurgeryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/14667

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