Breast cancer incidence after prophylactic mastectomy: a systematic review
DOI:
https://doi.org/10.18203/2349-3933.ijam20251941Keywords:
Prophylactic mastectomy, Breast cancer, IncidenceAbstract
Nowadays, many women in the world are living in fear of encountering breast cancer (BC). In 2020, WHO stated that BC is the most common cancer in the world and the fifth most common leading cause of cancer-related death. The progress made in medical science has made it possible for women to undergo prophylactic mastectomy (PM), which lowers their chances of developing BC. This article will discuss the incidence of BC after PM in women with no prior history of BC in one or both breast tissues. A systematic literature search was done in some databases, namely ProQuest, EBSCO, and PubMed, with a total of 380 articles. After a thorough screening, eight articles that met the criteria were enrolled. In addition, two articles were added from a manual search using Google Scholar. Of those articles, the risk of bias was assessed using the risk of bias tools from CLARITY. All articles suggested that most patients are middle-aged women, mostly around 45 years old. The surgical technique used in most cases is nipple-sparing mastectomy (NSM) due to its cosmetic advantage. Moreover, mutations in the BRCA gene were found to be positive in PM patients. The incidence of BC is substantially reduced after PM, reducing it to approximately 90%. The rest of it still has a chance to develop BC. PM may reduce the incidence of BC. However, further research, specifically on PM, is required to find out the long-term effect and efficacy.
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References
Giaquinto AN, Miller KD, Tossas KY, Winn RA, Jemal A, Siegel RL. Cancer statistics for African American/Black People 2022. CA Cancer J Clin. 2022;72(3):202-29. DOI: https://doi.org/10.3322/caac.21718
Miller KD, Ortiz AP, Pinheiro PS, Bandi P, Minihan A, Fuchs HE, et al. Cancer statistics for the US Hispanic/Latino population, 2021. CA Cancer J Clin. 2021;71(6):466-87. DOI: https://doi.org/10.3322/caac.21695
Breast cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/breast-cancer. Accessed on 5 June 2025.
Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, et al. Breast Cancer Statistics, 2022. CA Cancer J Clin. 2022;72(6):524-41. DOI: https://doi.org/10.3322/caac.21754
Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017;3(4):524-48.
Basu NN, Barr L, Ross GL, Evans DG. Contralateral risk-reducing mastectomy: review of risk factors and risk-reducing strategies. Int J Surg Oncol. 2015;2015:901046. DOI: https://doi.org/10.1155/2015/901046
What Are the Risk Factors for Breast Cancer? Centers for Disease Control and Prevention. 2022. Available at: https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm. Accessed on 5 June 2025.
PDQ Screening and Prevention Editorial Board. Breast Cancer Prevention (PDQ®): Patient Version. In: PDQ Cancer Information Summaries. Bethesda (MD): National Cancer Institute (US); 2002. Available at: http://www.ncbi.nlm.nih.gov/books/NBK65973/. Accessed on 5 June 2025.
Meijers-Heijboer H, van Geel B, van Putten WLJ, Henzen-Logmans SC, Seynaeve C, Menke-Pluymers MBE, et al. Breast Cancer after Prophylactic Bilateral Mastectomy in Women with a BRCA1 or BRCA2 Mutation. N Engl J Med. 2001;345(3):159-64. DOI: https://doi.org/10.1056/NEJM200107193450301
Hartmann LC, Sellers TA, Schaid DJ, Frank TS, Soderberg CL, Sitta DL, et al. Efficacy of Bilateral Prophylactic Mastectomy in BRCA1 and BRCA2 Gene Mutation Carriers. JNCI J Natl Cancer Inst. 2001;93(21):1633-7. DOI: https://doi.org/10.1093/jnci/93.21.1633
Alaofi RK, Nassif MO, Al-Hajeili MR. Prophylactic mastectomy for the prevention of breast cancer: Review of the literature. Avicenna J Med. 2018;8(3):67-77. DOI: https://doi.org/10.4103/ajm.AJM_21_18
Angelos P, Bedrosian I, Euhus DM, Herrmann VM, Katz SJ, Pusic A. Prophylactic Mastectomy. Ann Surg Oncol. 2015;22(10):3208-12. DOI: https://doi.org/10.1245/s10434-015-4758-y
Spear SL, Carter ME, Schwarz K. Prophylactic Mastectomy: Indications, Options, and Reconstructive Alternatives. Plast Reconstr Surg. 2005;115(3):891. DOI: https://doi.org/10.1097/01.PRS.0000153220.66955.39
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ. 2021;372.
Liede A, Cai M, Crouter TF, Niepel D, Callaghan F, Evans DG. Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect. Breast Cancer Res Treat. 2018;171(2):435–42. DOI: https://doi.org/10.1007/s10549-018-4824-9
Alvarado R, Lari SA, Roses RE, Smith BD, Yang W, Mittendorf EA, et al. Biology, treatment, and outcome in very young and older women with DCIS. Ann Surg Oncol. 2012;19(12):3777-84. DOI: https://doi.org/10.1245/s10434-012-2413-4
Hartmann LC, Schaid DJ, Woods JE, Crotty TP, Myers JL, Arnold PG, et al. Efficacy of Bilateral Prophylactic Mastectomy in Women with a Family History of Breast Cancer. N Engl J Med. 1999;340(2):77-84. DOI: https://doi.org/10.1056/NEJM199901143400201
Petrucelli N, Daly MB, Pal T. BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer. In: Adam MP, Mirzaa GM, Pagon RA, Wallace SE, Bean LJ, Gripp KW, et al. editors. GeneReviews®. Seattle (WA): University of Washington, Seattle. 1993.
Ashikari AY, Kelemen PR, Tastan B, Salzberg CA, Ashikari RH. Nipple sparing mastectomy techniques: a literature review and an inframammary technique. Gland Surg. 2018;7(3):273-87. DOI: https://doi.org/10.21037/gs.2017.09.02
Rebbeck TR, Friebel T, Lynch HT, Neuhausen SL, van ’t Veer L, Garber JE, et al. Bilateral Prophylactic Mastectomy Reduces Breast Cancer Risk in BRCA1 and BRCA2 Mutation Carriers: The PROSE Study Group. J Clin Oncol. 2004;22(6):1055-62. DOI: https://doi.org/10.1200/JCO.2004.04.188
Peled AW, Irwin CS, Hwang ES, Ewing CA, Alvarado M, Esserman LJ. Total skin-sparing mastectomy in BRCA mutation carriers. Ann Surg Oncol. 2014;21(1):37-41. DOI: https://doi.org/10.1245/s10434-013-3230-0
Manning AT, Wood C, Eaton A, Stempel M, Capko D, Pusic A, et al. Nipple-sparing mastectomy in patients with BRCA1/2 mutations and variants of uncertain significance. Br J Surg. 2015;102(11):1354-9. DOI: https://doi.org/10.1002/bjs.9884
Caramarie G, Christoudias M, Collett AE, Gracely EJ, Frazier TG, Barrio AV. Effect of Preoperative MRI on Mastectomy and Contralateral Prophylactic Mastectomy Rates at a Community Hospital by a Single Surgeon. The Breast J. 2014;20(1):79-83. DOI: https://doi.org/10.1111/tbj.12204
Dustin EL, Perdikis G, Rawal B, Bagaria S, McLaughlin SA. Incremental Risk Associated with Contralateral Prophylactic Mastectomy and the Effect on Adjuvant Therapy. Ann Surg Oncol. 2014;21(10):3297-303. DOI: https://doi.org/10.1245/s10434-014-3903-3
Moo TA, Tiffany P, Simone M, Alyssa L, Paul C, Hanan A, et al. Oncologic Outcomes After Nipple-Sparing Mastectomy. Ann Surg Oncol. 2016;23(10):3221-5. DOI: https://doi.org/10.1245/s10434-016-5366-1
Wevers MR, Aaronson NK, Verhoef S, Bleiker EMA, Hahn DEE, Kuenen MA, et al. Impact of Rapid Genetic Counselling and Testing on the Decision to Undergo Immediate or Delayed Prophylactic Mastectomy in Newly Diagnosed Breast Cancer Patients: Findings from a Randomised Controlled Trial. Brit J Cancer. 2014;110(4):1081-7. DOI: https://doi.org/10.1038/bjc.2013.805