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EP194/#91  Attitude of BRCA1/2 mutation carriers towards surgical risk reduction for breast, ovarian and uterine cancer
  1. Chen Nahshon1,2,
  2. Yakir Segev1,2,
  3. Meirav Schmidt1,2,
  4. Ludmila Ostrovsky1,2,
  5. Galia Oron1,2 and
  6. Ofer Lavie1,2
  1. 1Carmel Medical Center, Obstetrics and Gynecology, Haifa, Israel
  2. 2Technion-Israel Institute of Technology, Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel


Introduction BRCA1/2 mutation carriers are subjected to high rates of ovarian and breast cancer, thus recommendations for minimizing malignancy risk include risk reduction bilateral salpingo-oophorectomy (RRBSO), with or without hysterectomy and risk reduction mastectomy (RRM).

Methods This cross-sectional study was conducted by distribution of an anonymous questionnaire in social media platforms and BRCA1/2 mutation carriers medical clinic.

Results 530 BRCA1/2 mutation carriers answered the survey. RRBSO was discussed with 91% of patients and performed in 53%. Hormonal replacement therapy was discussed in 53% of patients. Addition of hysterectomy to RRBSO was discussed in 27% of patients and performed by 10%. Age over 35 years at time of mutation detection was found significant in raising RRBSO and hysterectomy performance rates. RRM was discussed in 83% of patients and performed in 33%. In a multivariate analysis, BRCA1 mutation carriers (OR 1.66 (95% CI 1.07–2.57) p=0.024) and a personal cancer history (OR 4.75 (95% CI 1.82–12.4) p=0.001) leading to the mutation detection were found significant in increasing the likelihood of opting RRM. Additionally, highest RRM performance rates were observed in the group of patients with a first-degree family history of breast cancer under the age of 50 years (OR 1.58 (95% CI 1.07–2.32) p=0.01).

Conclusion/Implications The data presented provides insights for the clinician counseling patients about their BRCA1/2 mutation, with not only explaining the risks and the acceptable recommendations, but also understanding their concerns and fears towards treatment and management alternatives and finally to construct a personalized management medical plan.

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