• Kandice K Ludwig, Joan Neuner, Annabelle Butler, Jennifer L Geurts, and Amanda L Kong.
• Department of Surgery, Indiana University School of Medicine, Carmel, IN, USA.
• Am. J. Surg. 2016 Oct 1; 212 (4): 660-669.

BackgroundMutations in BRCA1 or BRCA2 genes results in an elevated risk for developing both breast and ovarian cancers over the lifetime of affected carriers. General surgeons may be faced with questions about surgical risk reduction and survival benefit of prophylactic surgery.MethodsA systematic literature review was performed using the electronic databases PubMed, OVID MEDLINE, and Scopus comparing prophylactic surgery vs observation with respect to breast and ovarian cancer risk reduction and mortality in BRCA mutation carriers.ResultsBilateral risk-reducing mastectomy provides a 90% to 95% risk reduction in BRCA mutation carriers, although the data do not demonstrate improved mortality. The reduction in ovarian and breast cancer risks using risk-reducing bilateral salpingo-oophorectomy has translated to improvement in survival.ConclusionsClinical management of patients at increased risk for breast cancer requires consideration of risk, patient preference, and quality of life.Copyright © 2016 Elsevier Inc. All rights reserved.

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