Preventief chirurgisch ingrijpen bij erfelijke belasting voor borstkanker

- For women with a demonstrated BRCA1 or BRCA2 mutation, the cumulative risk of developing invasive breast cancer before the age of 70 years is about 50-85 and the risk of developing invasive epithelial ovarian cancer is 20-60.

- Regular surveillance including physical examination and imaging is offered to mutation carriers and the options for risk-reducing surgery are discussed.

- Although bilateral prophylactic mastectomy is a drastic intervention, it significantly reduces the incidence of breast cancer.

- For mutation carriers with breast cancer, the decision to combine risk-reducing surgery with treatment is determined by the TNM stage of the disease.

- Prophylactic bi- or contralateral mastectomy after previous treatment for unilateral breast cancer reduces the incidence of contralateral breast cancer, but has no impact on survival.

- The complexity of the problem demands a multidisciplinary approach within the context of a family cancer clinic.

Ned Tijdschr Geneeskd. 2005;149:2663-7