Erschienen in:
31.08.2016 | Breast Oncology
Outcomes of Concurrent Breast and Gynecologic Risk Reduction Surgery
verfasst von:
Irene T. Ma, MD, Richard J. Gray, MD, Nabil Wasif, MD, MPH, Kristina A. Butler, MD, Jeffrey L. Cornella, MD, Javier F. Magrina, MD, Paul M. Magtibay, MD, William J. Casey, MD, Raman Mahabir, MD, Alanna M. Rebecca, MD, MPH, Katherine S. Hunt, MS, PhD, CGC, Barbara A. Pockaj, MD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 1/2017
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Abstract
Background
Women considering risk reduction surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated multispecialty surgery.
Methods
We conducted a retrospective review of patients undergoing simultaneous breast and gynecologic surgery for newly or previously diagnosed breast cancer and/or an inherited cancer gene mutation during the same anesthetic at a single institution from 1999 to 2013.
Results
Seventy-three patients with a mean age of 50 years (range 27–88) were identified. Most patients had newly diagnosed breast cancer or ductal carcinoma in situ (62 %) and 28 patients (38 %) had an identified BRCA mutation. Almost all gynecologic procedures were for risk reduction or benign gynecologic conditions (97 %). Mastectomy was performed in 39 patients (53 %), the majority of whom (79 %) underwent immediate reconstruction. The most common gynecologic procedure involved bilateral salpingo-oophorectomy, which was performed alone in 18 patients (25 %) and combined with hysterectomy in 40 patients (55 %). A total of 32 patients (44 %) developed postoperative complications, most of which were minor and did not require surgical intervention or hospitalization. Two of the 19 patients who underwent implant reconstruction (11 %; 3 % of the entire cohort) had major infectious complications requiring explantation.
Conclusion
Combined breast and gynecologic procedures for a breast cancer diagnosis and/or risk reduction in patients can be accomplished with acceptable morbidity. Concurrent operations, including reconstruction, can be offered to patients without negatively impacting their outcome.