Prophylactic nipple-sparing mastectomy in young previvors: Examining decision-making, reconstructive outcomes, and patient satisfaction in BRCA+ patients under 30

Breast J. 2020 May;26(5):971-975. doi: 10.1111/tbj.13692. Epub 2019 Nov 17.

Abstract

Bilateral prophylactic mastectomies (BPM) in young previvors with high-risk mutations are rising; however, little data on management, therapy timing, and outcomes exist. BRCA+ patients under 30 undergoing BPM from 2006 to 2018 were reviewed. Twenty-two patients aged 23-29 underwent mastectomy 4.2 years after genetic diagnosis. Twelve patients completed surveys, most often citing personal decisions (50%) for undergoing mastectomy and plastic surgeons' recommendations (83.3%) for reconstruction. About 73% of patients completely understood risks/benefits of mastectomy and 63.6% of reconstruction. Patients reported high BREAST-Q Satisfaction and Well-Being scores. Continued educational resource development will optimize shared decision-making in the reconstructive process.

Keywords: BRCA; nipple-sparing mastectomy; previvor; quality-of-life.

MeSH terms

  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Mammaplasty*
  • Mastectomy
  • Mastectomy, Subcutaneous*
  • Nipples / surgery
  • Patient Satisfaction
  • Prophylactic Mastectomy*