Having a Breast Augmentation? Get tested for BRCA?

I never thought I would be reading the Aesthetic Surgery Journal.....but when the word BRCA pops up, I have to take notice.

From Medical News Today

"Plastic surgeons must play a part in monitoring women who come in for cosmetic breast procedures. These patients should be assessed for potential breast cancer risk by a physical examination as well as a family history evaluation," said Foad Nahai, MD, President of ASAPS and Associate Editor of ASJ. "It is imperative that these patients understand their potential risk, if any, as well as the implications breast surgery may have on future screening, in order for them to make the best possible decision regarding their own care."

I never thought I could tell the guys from Nip Tuck to do a 3 generation pedigree.....Well, Now I can. There is a problem though...I don't think plastic surgeons are the most astute genetic counselors out there.....

So what does this article say?

"Before every elective breast surgery, special attention should be paid to any family history of breast or ovarian cancer."

The reason? Since you are working with young women, this is the ideal group to identify these risks.... They demonstrated the PAT model and also show the gail model.......Both are not the best choices and can underestimate risk. Still with the BRCAPRO model, physicians need to know that limited family structure can play a role...something most physicians miss.

From Medical News Today:

Some key considerations for patients at high risk for breast cancer include:

- BRCA1 and BRCA2 related breast cancers generally occur in younger women, making detection by mammography difficult because of the denser breasts.

- The current screening recommendations for patients who test positive for BRCA1 and BRCA2 mutations include monthly self breast exams starting at age 18, semiannual clinical breast exams starting at age 25, and annual mammography and breast MRI starting at age 30.

- All breast reconstruction methods are available to patients with genetic predisposition for developing breast cancer; however, every high-risk patient must be counseled carefully and thoroughly to enable her to arrive at a decision suitable for her.

- For patients with BRCA mutation, it is important to note that bilateral reconstructions can be very lengthy and a staged approach may be advisable, and must be coordinated with the oncologic and gynecologic surgeons during combined procedures.



"Close cooperation between oncologists and plastic surgeons will improve patients' psychosocial outcomes and decrease the psychological burden for patients who have been diagnosed with a genetic predisposition for breast cancer," added Dr. Soltanian.



The Sherpa Says:
How sad is it that the only time a woman may get her family history evaluated is when she is seeing a plastic surgeon for breast augmentation......BTW did you notice that Dr Soltanian did not mention Medical Geneticists....I wonder if they know medical genetics exists????