'Awareness of BRCA Status Drives Aggressive Surgery in Early-Onset Breast Cancer'

 At the San Antonio Breast Cancer Symposium, investigators from an international consortium reported that knowledge of BRCA1/2 mutation status strongly influenced surgical decision-making in young patients with stages I-III breast cancer.

In this MedPage Today video, Halle Moore, MD, of the Cleveland Clinic, discusses the findings and their implications for genetic testing and treatment planning.

Following is a transcript of her remarks:

This study came out of a multi-institutional collaboration called the BRCA BCY group, which is an international group of centers that are looking retrospectively at patients diagnosed with young-onset breast cancer who carry BRCA1 or BRCA2 pathogenic or suspected pathogenic mutations.

And in this analysis, we looked at surgical choices amongst these patients. And between the years of 2000 and 2020, patients were looked at for the type of surgery. And we found that about a quarter of the patients underwent bilateral mastectomy, with either unilateral mastectomy or breast-conserving surgery split between the remaining 75% of patients.

What we also found was that use of bilateral mastectomy increased over time in this cohort, and the greatest predictor for use of bilateral mastectomy was known BRCA status at the time of their surgical choice. So what that tells us is that you're more likely to do more aggressive surgery and risk-reducing surgery for the contralateral breast if you know about your mutation carrier status when you're diagnosed.

Why do we care about that? Are we overtreating? Are we undertreating? In fact, we also from the same cohort previously published that those who underwent bilateral mastectomy had improved survival compared with those who don't.

So I think the real message from this study is the importance for our young-onset breast cancer patients to undergo genetic testing and know their genetic status at the time of treatment decision-making.

https://www.medpagetoday.com/meetingcoverage/sabcs-vp-earlybrca/119012