Risk-reducing mastectomy in BRCA carriers: survival is not the issue

  • P. NevenEmail author
  • K. Punie
  • H. Wildiers
  • N. Willers
  • C. Van Ongeval
  • G. Van Buggenhout
  • E. Legius
Letter to the Editor

To the editor,

Heemskerk-Gerritsen et al. [1] followed 739 women with a germline pathogenic BRCA2 variant and observed 7 deaths during 8.6 years (6.5–11.7), the median follow-up period since individual DNA diagnosis. They conclude based on their findings in this cohort that breast cancer mortality is so low that women carrying BRCA2 mutations should be informed that risk-reducing mastectomy (RRM) is an over-treatment. This was first a headline in the lay press ‘Algemeen Dagblad’, edition July 29th, ‘prophylactic breast amputation does not seem necessary’ followed by almost any Flemish newspaper.

The 739 female BRCA2 carriers had a median age of 42 years (33–51) at genetic diagnosis, the start of the observation period. After a median follow-up of 8.6 years, 144 women (19.5%) developed breast cancer at a median age of 48 years (39–55) and 7 patients (0.9% of carriers, 6% of patients diagnosed with invasive cancer) died of breast cancer. This 0.9% breast cancer mortality in the first...



  1. 1.
    Heemskerk-Gerritsen BAM, Jager A, Koppert LB et al (2019) Survival after bilateral risk-reducing mastectomy in healthy BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Heemskerk-Gerritsen BA, Menke-Pluijmers MB, Jager A et al (2013) Substantial breast cancer risk reduction and potential survival benefit after bilateral mastectomy when compared with surveillance in healthy BRCA1 and BRCA2 mutation carriers: a prospective analysis. Ann Oncol 24(8):2029–2035CrossRefPubMedGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Multidisciplinary Breast Centre and Leuven University Centre for Cancer Prevention (LUCK)University Hospitals LeuvenLouvainBelgium
  2. 2.Department of Human GeneticsUniversity Hospitals LeuvenLouvainBelgium

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