A 38-year-old woman with a BRCA1 pathogenic variant wishes to undergo risk-reducing bilateral mastectomy. She has no personal history of breast cancer. Regarding this procedure, which statement is correct?

• A Risk-reducing mastectomy reduces breast cancer risk by approximately 50 percent
• B Risk-reducing mastectomy reduces breast cancer risk by over 90 percent ✓
• C Nipple-sparing mastectomy is contraindicated in BRCA carriers
• D Total (simple) mastectomy leaves significant breast tissue and does not reduce risk

Explanation

Risk-reducing bilateral mastectomy reduces breast cancer risk by over 90 percent in BRCA carriers. Nipple-sparing mastectomy is not absolutely contraindicated in selected BRCA carriers, though some surgeons prefer skin-sparing with nipple removal. Total mastectomy removes the majority of breast tissue, including the nipple-areola complex in standard simple mastectomy, and is effective. The risk reduction is not 50 percent; it exceeds 90 percent.

Reference: Harrisons Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.