When to perform risk reducing surgery if BRCA positive patients?

Rodrigo Arrangoiz MS, MD, FACS, FSSO
👉The risk for ovarian cancer in BRCA1 mutation carriers ranges from 36% to 63%.
👉In a prospective multicenter cohort study of women with BRCA1 or BRCA2 mutations, women who underwent risk-reducing salpingo-oophorectomy had a lower risk of ovarian cancer, including those with or without prior breast cancer, and a lower risk of first diagnosis of breast cancer.
👉Undergoing a risk-reducing salpingo-oophorectomy was also associated with a lower all-cause mortality, breast cancer specific mortality, and ovarian cancer specific mortality.

👉Computer modeling has found that performing a prophylactic oophorectomy at age 40 years and prophylactic mastectomy at age 25 years, is the most effective combination strategy to obtain a 26% survival gain by age 70 years compared with no interventions.

👉However, performing a prophylactic oophorectomy early in life can limit reproductive options and cause early menopause and its accompanying health risks. 

👉In a recent study of 5783 BRCA1 and BRCA2 mutation carriers from a prospective international registry, preventive oophorectomy was associated with an 80% reduction in the risk of ovarian, fallopian tube, or peritoneal cancer and a 77% reduction in all-cause mortality.

👉The authors also concluded that the data support the recommendation for BRCA1 mutation carriers to undergo oophorectomy at age 35 years.

👉After this age, the risk of ovarian cancer increases. 

Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y miembro de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

  • Es experto en el manejo del cáncer de mama.

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

#Arrangoiz

#Surgeon

#Cirujano

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

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http://www.sociedadquirurigca.com

REFERENCES

  1. Domchek S, Friebel TM, Singer CF, et al. Association of risk-reducing surgery in BRCA1 and BRCA2 mutation carriers with cancer risk and mortality. JAMA. 2010;9:967-975. http://www.ncbi.nlm.nih.gov/pubmed/20810374
  2. Finch AP, Lubinski J, Møller P, et al. Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. J Clin Oncol. 2014;32:1547-1553. http://www.ncbi.nlm.nih.gov/pubmed/24567435
  3. Guillem JG, Wood WC, Moley JF, et al; ASCO; SSO. ASCO/SSO review of current role of risk-reducing surgery in common hereditary cancer syndromes. J Clin Oncol. 2006;24:4642-4660. http://www.ncbi.nlm.nih.gov/pubmed/17008706
  4. Kurian AW, Sigal BM, Plevritis SK. Survival analysis of cancer risk reduction strategies for BRCA1/2 mutation carriers. J Clin Oncol. 2010;28:222-230. http://www.ncbi.nlm.nih.gov/pubmed/19996031
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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