A 38-year-old BRCA2 mutation carrier requests risk-reducing bilateral salpingo-oophorectomy (RRBSO) and risk-reducing mastectomy (RRM). Which statement accurately reflects current evidence-based counseling?

• A RRBSO reduces breast cancer risk by 50% in BRCA1 carriers and 60% in BRCA2 carriers
• B RRBSO eliminates ovarian cancer risk completely in BRCA carriers
• C RRM provides greater survival benefit in BRCA2 than BRCA1 carriers
• D RRM reduces breast cancer risk by approximately 90-95% regardless of BRCA status ✓

Explanation

Risk-reducing mastectomy (bilateral prophylactic mastectomy) reduces breast cancer risk by approximately 90-95% in both BRCA1 and BRCA2 carriers, as it cannot remove all breast tissue. RRBSO reduces breast cancer risk by approximately 50% in BRCA1 carriers but up to 72% in BRCA2 carriers (due to hormone-driven BRCA2 cancers). RRBSO reduces but does not eliminate ovarian/peritoneal cancer risk (primary peritoneal carcinoma can still occur). Survival benefit from RRM is greater in younger women with higher absolute risk.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.