Evidence map›Paper›PMID 37838650›Full record

ArticleAnnals of surgical oncology2024

Surgical Decision Making in Genetically High-Risk Women: Quantifying Postoperative Complications and Long-Term Risks of Supplemental Surgery After Risk-Reducing Mastectomy.

Carla Apostolova, Amina Ferroum, Basmah Alhassan, Ipshita Prakash, Alex Viezel-Mathieu, Mark Basik, Jean Francois Boileau, Sarkis Meterissian, Nora Wong, William D Foulkes and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Perioperative safety of risk-reducing mastectomy.British journal of cancer · 2024
    Article
  5. Counselling Framework for GermlineCurrent oncology (Toronto, Ont.) · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Carla ApostolovaDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Amina FerroumDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Basmah AlhassanDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Ipshita PrakashDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Alex Viezel-MathieuDepartment of Plastic and Reconstructive Surgery, McGill University Medical School, Montreal, QC, Canada.
Mark BasikDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Jean Francois BoileauDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Sarkis MeterissianDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada.
Nora WongStroll Cancer Prevention Centre, Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada.
William D FoulkesStroll Cancer Prevention Centre, Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada.
Stephanie M WongDepartment of Surgery, McGill University Medical School, Montreal, QC, Canada. sm.wong@mcgill.ca.
McGill University · CAJewish General Hospital · CA

Funding

Fonds de Recherche du Québec - Santé 309854
6 · The paper itself

Abstract

backgroundRisk-reducing mastectomy (RRM) helps prevent breast cancer in high-risk women but also carries a risk of unanticipated supplemental surgeries. We sought to determine the likelihood of supplemental surgeries following RRM.

methodsWe performed a retrospective cohort study of female patients with a confirmed germline pathogenic variant (GPV) in a breast cancer susceptibility gene (BRCA1/2, PALB2 and others) who underwent bilateral or contralateral RRM at our institution between 2006 and 2022. Supplemental surgeries were defined as any operation requiring general or local anesthesia performed outside of the initially planned procedure(s). The Kaplan-Meier method was used to estimate the 5-years cumulative incidence of supplemental surgery.

resultsOf 560 GPV carriers, RRMs were performed in 258 (46.1%) women. The median age of the cohort was 44 years (interquartile range 37-52 years), with 33 (12.8%) patients undergoing RRM without reconstruction and 225 (87.2%) undergoing RRM with reconstruction. Following surgery, 34 patients (13.2%) developed early (< 30 days) postoperative complications, including infection, hematoma, seroma, loss of the nipple areola complex, flap necrosis, implant exposure and/or prosthesis removal. At a median follow-up of 3.8 years, 94 (36.4%) GPV carriers underwent at least one reoperation. Participants who experienced an early postoperative complication had the highest rate of reoperation (85.3% vs. 29.0%; p < 0.001) and a significantly higher likelihood of multiple additional surgical interventions (41.2% vs. 10.7%; p < 0.001). The 5-years rate of supplemental surgery was 39.2% [95% confidence interval (CI) 32.7-46.5] in the overall cohort and 31.5% (95% CI 24.9-39.3) in patients without an early postoperative complication.

conclusionsUnanticipated supplemental surgeries occur in 40% of GPV carriers following RRM and in nearly one-third of patients without early postoperative complications.

Indexed as

Breast NeoplasmsMammaplastyAdultBRCA1 ProteinBRCA2 ProteinDecision MakingFemaleHumansMastectomyMiddle AgedPostoperative ComplicationsRetrospective StudiesBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, humanBRCA1/2Breast neoplasmsReoperationRisk-reducing mastectomySupplemental surgery

Identifiers

PMID37838650
OpenAlexW4387638122

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.