Current knowledge of risk reducing mastectomy: Indications, techniques, results, benefits, harms
Autor: | Andrew D Baildam |
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Rok vydání: | 2019 |
Předmět: |
Oncology
Adult medicine.medical_specialty Reconstructive surgery Health Knowledge Attitudes Practice medicine.medical_treatment Genes BRCA2 Genes BRCA1 Breast Neoplasms 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Humans Raloxifene 030212 general & internal medicine Family history skin and connective tissue diseases business.industry fungi Prophylactic Mastectomy General Medicine medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Surgery Female Breast reconstruction business Risk Reduction Behavior Tamoxifen Mastectomy medicine.drug |
Zdroj: | Breast (Edinburgh, Scotland). 46 |
ISSN: | 1532-3080 |
Popis: | The last twenty years have seen a complete change in society's attitude to the strategy of risk reduction of breast cancer in high-risk individuals by means of proactive mastectomy. Once termed 'prophylactic mastectomy', risk reducing mastectomy (RRM) was considered two decades ago not only extreme, but in some quarters almost unethical. RRM is now commonly undertaken in specialist breast units for women at high individual breast cancer risk, by virtue of an inherited breast cancer related gene mutation or from calculated high statistical risk from family history data, and the efficacy of RRM in reducing subsequent incident diagnoses of breast cancer has been published from a number of centres. RRM is offered routinely in conjunction with total breast reconstruction, using the whole range of reconstructive surgical techniques. The public announcement by the actor Angelina Jolie in 2013 that she had inherited and harboured a BRCA1 gene mutation, and was undergoing RRM and breast reconstruction to lower her intrinsic breast cancer risk, had a significant effect on public attitudes and perception. Whilst there are other means of lowering breast cancer risk by means of selective oestrogen receptor modulators, such as tamoxifen and raloxifene, their lowering effect on risk of breast cancer remains substantially less than that afforded by surgical removal of 'at risk' breast tissue. The progressive development and increasing sophistication of techniques of breast reconstructive surgery has paralleled the trend for more RRM surgery, and the substantial majority of women who opt for RRM choose immediate breast reconstruction. |
Databáze: | OpenAIRE |
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