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Risk reducing mastectomy: outcomes in 10 European Centres
  1. Gareth Evans (gareth.evans{at}cmmc.nhs.uk)
  1. St Mary's Manchester, United Kingdom
    1. Andrew Baildam (andrew.baildam{at}christie.nhs.uk)
    1. Wythenshawe Hospital, United Kingdom
      1. Anne Brain (anne.brain{at}christie.nhs.uk)
      1. Wythenshawe Hospital, United Kingdom
        1. Elaine Anderson (donna.smart{at}sbsp.scot.nhs.uk)
        1. South East Scotland Breast Screening Programme, United Kingdom
          1. Andrew Shenton (andrew.shenton{at}cmmc.nhs.uk)
          1. St Mary's Hospital, United Kingdom
            1. Hans F.A. Vasen (hfavasen{at}stoet.nl)
            1. Netherlands Foundation for the Detection of Hereditary Tumours, Netherlands
              1. Diana Eccles (de1{at}soton.ac.uk)
              1. Southampton University, United Kingdom
                1. Anneke m Lucassen (annekel{at}soton.ac.uk)
                1. University of Southampton, United Kingdom
                  1. Gabriella Pichert (gabriella.pichert{at}gstt.nhs.uk)
                  1. Guys Hospital, United Kingdom
                    1. Hisham Hamed (hishhamed{at}aol.com)
                    1. Guys Hospital, United Kingdom
                      1. Pål Møller (pmoller{at}ulrik.uio.no)
                      1. Norwegian Radium Hospital, Norway
                        1. Lovise Mahle (l.o.mahle{at}medisin.uio.no)
                        1. Norwegian Radium Hospital, Norway
                          1. Patrick Morrison (patrick.morrison{at}bch.ni.nhs.uk)
                          1. Belfast City Hospital, United Kingdom
                            1. Dominique Stoppat-Lyonnet (dominique.stoppa-lyonnet{at}curie.net)
                            1. Institu Curie, France
                              1. Helen Gregory (h.gregory{at}abdn.ac.uk)
                              1. University of Aberdeen, United Kingdom
                                1. Elizabeth Smyth (e.smyth{at}abdn.ac.uk)
                                1. University of Aberdeen, United Kingdom
                                  1. Dieter Niederacher (niederac{at}uni-duesseldorf.de)
                                  1. University Medical Clinic Düsseldorf, Germany
                                    1. Christine Nestle-Krämling (nestle-kraemling{at}med.uni-duesseldorf.de)
                                    1. University Medical Clinic Düsseldorf, Germany
                                      1. Joyce Campbell
                                      1. South East Scotland Breast Screening Programme, United Kingdom
                                        1. Fiona Lalloo (fiona.lalloo{at}cmmc.nhs.uk)
                                        1. St Marys Hospital, Manchester, United Kingdom
                                          1. Anthony Howell (anthony.howell{at}christie.nhs.uk)
                                          1. Christie Hospital, United Kingdom

                                            Abstract

                                            Background: Increasingly women at high risk of breast cancer are opting for risk reducing surgery. The aim of this study was to assess the effectiveness of this approach in women at high risk in both carriers and non-carriers of BRCA1/2.

                                            Methods: Data from 10 European centres that offer a genetic counselling and screening service to women at risk have been obtained prospectively from 1995. Breast cancer risks were estimated from life tables and a control group of women at risk who did not undergo surgery.

                                            Results: The combined centres have data on 550 women who have undergone risk reducing mastectomy with greater than 3334 women years of follow up. Operations were carried out on women with lifetime risks of 25-80%, with an average expected incidence rate of 1% per year. No breast cancers have occurred in this cohort in the “at risk” unaffected breast, whereas >34 would have been expected. A high rate (2-3.6%) of occult disease was identified in the at risk breast at the time of surgery.

                                            Interpretation: We conclude that risk reducing surgery is highly effective.

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