• M B E Menke-Pluymers, C Seynaeve, A N van Geel, J G M Klijn, E J Meijers-Heijboer, and A M M Eggermont.
• Erasmus MC-Daniel den Hoed Oncologisch Centrum, Postbus 5201, 3008 AE Rotterdam. m.menke@erasmusmc.nl
• Ned Tijdschr Geneeskd. 2005 Nov 26; 149 (48): 2663-7.

AbstractPreventive surgical procedures for inherited risk of breast cancer Forwomen with a demonstrated BRCA1 or BRCA2 mutation, the cumulative risk of developing invasive breast cancer before the age of 70 years is about 50-85% and the risk of developing invasive epithelial ovarian cancer is 20-60%. Regular surveillance including physical examination and imaging is offered to mutation carriers and the options for risk-reducing surgery are discussed. Although bilateral prophylactic mastectomy is a drastic intervention, it significantly reduces the incidence of breast cancer. For mutation carriers with breast cancer, the decision to combine risk-reducing surgery with treatment is determined by the TNM stage of the disease. Prophylactic bi- or contralateral mastectomy after previous treatment for unilateral breast cancer reduces the incidence of contralateral breast cancer, but has no impact on survival. The complexity of the problem demands a multidisciplinary approach within the context of a family cancer clinic.

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