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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Bilateral Risk-Reducing Prophylactic Mastectomies in an Unaffected BRCA1 Carrier Using Dermal Sling and Implant.

Sandhya Gupta1,2, Geeta Kadayaprath2, Neerja Gupta2

  • 1Department of Surgical Oncology, MICC, New Delhi, India.

Indian Journal of Surgical Oncology
|January 17, 2022
PubMed
Summary

Hereditary breast cancer (HBC) patients with BRCA1 mutations face high lifetime risks. This case highlights bilateral risk-reducing surgeries in a 37-year-old BRCA1 carrier, emphasizing the need for greater acceptance in India.

Keywords:
BRCA 1 carrierDermal slingImplant-assisted reconstructionNipple sparing mastectomiesProphylactic bilateral mastectomies

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Area of Science:

  • Oncology
  • Genetics
  • Surgical Oncology

Background:

  • Hereditary breast cancer (HBC) constitutes 5-10% of all breast cancer cases, frequently caused by BRCA1 and BRCA2 mutations.
  • BRCA mutation carriers exhibit significantly elevated lifetime breast cancer risks, necessitating proactive risk-management strategies.

Observation:

  • A case report details bilateral risk-reducing prophylactic mastectomies (B/L RRM) and bilateral risk-reducing salpingo-oophorectomy (B/L RRSO) in a 37-year-old healthy BRCA1 carrier.
  • The patient, a BRCA1 mutation carrier, underwent prophylactic surgeries to mitigate cancer risk.

Findings:

  • Prophylactic surgeries like B/L RRM and B/L RRSO are established risk-reduction measures for high-penetrance BRCA mutation carriers.
  • Despite established efficacy, acceptance of these procedures in India remains low due to various socioeconomic and cultural factors.

Implications:

  • This case underscores the importance of risk-reducing surgeries for BRCA mutation carriers.
  • Addressing barriers such as cost, stigma, and awareness is crucial to improve the uptake of these life-saving procedures in India.