Prophylactic Mastectomy and Genetic Testing: An Update

Purpose/Objectives: To examine and discuss the pos­sible benefits and difficulties with recommending pro­phylactic mastectomy to BRCA1- and BRCA2-positive women. 

Data Sources: Published research articles, profes­sional review articles, textbooks. 

Data Synthesis: Women with BRCA1 and BRCA2 mu­tations face a much higher risk of developing breast cancer than the general population, with limited op­tions available for prevention. Prophylactic mastec­tomy has been shown to have a survival advantage in young women who carry BRCA1 and BRCA2 mutations. Challenges exist, however, in the use of prophylactic mastectomy and genetic testing. 

Conclusions: Methods of preventing breast cancer In BRCA1- and BRCA2-positive women currently are lim­ited to watch-and-wait surveillance, prophylactic mas­tectomy, and, perhaps, chemoprevention. Genetic 

testing and prophylactic mastectomy each present unique challenges while offering certain benefits as well. Recent studies have shown survival advantages to BRCA1- and BRCA2-positive women who undergo pro­phylactic mastectomy. 

Implications for Nursing Practice: Nurses need to be aware of the complex Issues surrounding testing for BRCA1 and BRCA2 mutations and prophylactic mas­tectomy to be able to provide current information to patients and assist in decision making.