The Manchester guidelines for contralateral risk-reducing mastectomy

World Journal of Surgical Oncology

L Barr³  D G Evans⁴  G L Ross¹  Narendra Nath Basu² 

[1] The Institute of Cancer Sciences, The University of Manchester, Oxford Road, Manchester M13 9PL, UK;Queen Elizabeth Hospital, Birmingham B15 2TH, UK;Nightingale and Genesis Prevention Centre, University Hospital South Manchester, Southmoor Road, Manchester M23 9LT, UK;St. Mary’s Hospital, Oxford Road, Manchester M13 9WL, UK

关键词: Multi-disciplinary team;    Guidelines;    Risk-reducing mastectomy;    Breast cancer;    Contralateral;   

Others  :  1223988
DOI  :  10.1186/s12957-015-0638-y

 received in 2015-03-11, accepted in 2015-06-30,  发布年份 2015

【 摘 要 】

Background

Rates of contralateral risk-reducing mastectomy (CRRM) are rising, despite a decreasing global incidence of contralateral breast cancer. Reasons for requesting this procedure are complex, and we have previously shown a variable practice amongst breast and plastic surgeons in England. We propose a protocol, based on a published systematic review, a national UK survey and the Manchester experience of CRRM.

Methods

We reviewed the literature for risk factors for contralateral breast cancer and have devised a 5-step process that includes history taking, calculating contralateral breast cancer risk, cooling off period/counselling, multi-disciplinary assessment and consent. Members of the multi-disciplinary team included the breast surgeon, plastic surgeon and geneticist, who formulated guidelines.

Results

A simple formula to calculate the life-time risk of contralateral breast cancer has been devised. This allows stratification of breast cancer patients into different risk-groups: low, above average, moderate and high risk. Recommendations vary according to different risk groups.

Conclusion

These guidelines are a useful tool for clinicians counselling women requesting CRRM. Risk assessment is mandatory in this group of patients, and our formula allows evidence-based recommendations to be made.

【 授权许可】

   
2015 Basu et al.

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