Risk reducing bilateral mastectomy for BRCA1/2 mutation carriers (#85)
Women identified as BRCA1 or BRCA2 gene mutation carriers have a high lifetime risk of developing breast and/or ovarian cancer. A number of options are available to women to manage the increased breast cancer risk including breast cancer screening (mammogram, breast MRI) with the aim being to detect breast cancer at its earliest stage. Options to reduce breast cancer risk include chemoprevention (Tamoxifen) or risk reducing mastectomy.
The uptake of risk reducing mastectomy varies between countries. In the UK approximately 40% of female BRCA1/2 carriers undergo risk reducing mastectomy. In Denmark it is 50% whilst in Australia it is 25%. A number of factors have been identified which impact on whether a woman decides to have risk reducing mastectomy including lifetime risk, age, childbirth and experiential knowledge.
In addition to the medical implications of reducing breast cancer risk, cosmetic outcome and quality of life issues must be explored with women pre operatively utilising the skills and expertise of a multidisciplinary team, including genetics, surgery (including plastics), psychology/psychiatry and nursing. Peer support can also be advantageous.
BRCA1/2 gene mutation carriers who have had risk reducing mastectomy have been shown to have less favourable body image, report changes in sexual relationship therefore the impact of risk reducing mastectomy cannot be underestimated. A major psychological benefit of risk reducing mastectomy for women is reduction in the fear of developing breast cancer.
This presentation will explore the psychological implications for female BRCA1/2 mutation carriers considering or who have undergone risk reducing mastectomy.