A 45-year-old woman is found to have BRCA1 mutation on genetic testing after her sister died of ovarian cancer. She has no personal history of breast cancer. Which statement about risk-reducing mastectomy in BRCA1 carriers is MOST accurate?
- A It reduces breast cancer risk by approximately 50%
- B It reduces breast cancer risk by approximately 90-95% ✓
- C It eliminates all risk since all breast tissue is removed
- D It is only indicated if BRCA2 is also mutated
Correct answer: B. It reduces breast cancer risk by approximately 90-95%
Explanation
Risk-reducing bilateral mastectomy in BRCA1/BRCA2 carriers reduces breast cancer risk by approximately 90-95%, not 100%, because microscopic residual breast tissue may remain despite complete mastectomy. BRCA1 carriers have a lifetime breast cancer risk of 55-72%, so this intervention is highly effective. Risk-reducing salpingo-oophorectomy additionally reduces breast cancer risk in BRCA1 carriers by about 50%.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.