Usage Patterns of Surveillance, Chemoprevention and Risk-Reducing Surgery in Korean BRCA Mutation Carriers: 5 Years of Experience at a Single Institution / 한국유방암학회지

ABSTRACT

PURPOSE: Options for BRCA mutation carriers include close surveillance, chemoprevention, and risk-reducing surgery (RRS) for breast and ovarian cancer. However, chemoprevention and RRS for cancer prevention are not widely performed in Korea. The aim of this study was to investigate the usage patterns of surveillance, chemoprevention and RRS of breast and ovary in Korean BRCA mutation carriers. METHODS: We retrospectively reviewed the medical record of 67 women who were diagnosed with BRCA1 or BRCA2 mutation between January 2005 and May 2009 at Seoul National University Bundang Hospital. RESULTS: Mean age was 46 years old (range, 27-73 years), and median follow-up period was 10 months. The numbers of affected and unaffected carriers were 50 (74.6%) and 17 (25.4%). In 47 women affected with breast cancer excluding 3 cases of concurrent breast/ovarian cancers, 42 (89.4%) have received intensive surveillance only, 2 (4.3%) have taken tamoxifen for chemoprevention, and 3 (6.4%) have undergone contralateral prophylactic mastectomies to prevent breast cancer. For ovarian cancer prevention, risk reducing salpingo-oophorectomy was performed in 11 (24.4%) of 45 affected carriers excluding 5 patients who had bilateral salphingo-oophorectomy previously. In 17 unaffected carriers, chemoprevention and RRS were not performed. Only 4 (23.5%) of these unaffected carriers have chosen surveillance for breast or ovarian cancer. Old age and no family history are related to the poor compliance (no follow-up) of the carriers only in the univariate analysis but not in the multivariate analysis. CONCLUSION: Most of the Korean affected BRCA mutation carriers in our study chose intensive surveillance rather than chemoprevention or RRS. We should take special effort to follow and educate unaffected carriers, especially for those with old age or no family history.