Practice Patterns of Surgeons for the Management of Hereditary Breast Cancer in Korea

Ku Sang Kim; Sung-Won Kim; Min Hyuk Lee; Sei Hyun Ahn; Sue Kyung Park

doi:10.4048/jbc.2008.11.2.95

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Kim, Kim, Lee, Ahn, Park, and Korean Breast Cancer Society: Practice Patterns of Surgeons for the Management of Hereditary Breast Cancer in Korea

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2008; 11(2): 95-101.

Published online: 30 June 2008

DOI: https://doi.org/10.4048/jbc.2008.11.2.95

Practice Patterns of Surgeons for the Management of Hereditary Breast Cancer in Korea

Ku Sang Kim, Sung-Won Kim, Min Hyuk Lee¹, Sei Hyun Ahn², Sue Kyung Park³; Korean Breast Cancer Society

Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

¹Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.

²Department of Surgery, Ulsan University College of Medicine, Seoul, Korea.

³Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.

Korean Breast Cancer Society, Seoul, Korea.

brcakorea@gmail.com

Received 18 December 2007 Accepted 17 March 2008

Abstract

Purpose

The aim of this study is to examine practice patterns of surgeons for the management of hereditary breast cancer in Korea.

Methods

A structured questionnaire was circulated to the members of the Korean Breast Cancer Society through e-mail distribution between 6 July and 14 August 2007. A total of 43 surgeons from 42 hospitals responded to the survey.

Results

Of the respondents, 81.4% (n=35) asked for information related to the family histories of cancer and 58.1% (n=25) recommended genetic testing for their patients. Indications for genetic testing recommended by the 25 surgeons were the following: breast cancer patients with family histories of breast or ovarian cancer (96%), bilateral breast cancer (80%), early-onset (64%) or male breast cancer (52%), and a double primary malignancy with breast and ovarian cancer (36%). Of the respondents, 52% (13/25) performed genetic counseling before genetic testing, and the surgeons (81.3%, 13/16) or genetic counselors (18.7%, 3/16) provided the genetic counseling. Although 154 BRCA1/2 mutation carriers of 95 families have been identified so far, only 12 family members were managed for prophylaxis by tamoxifen chemoprevention (n=2), a contralateral prophylactic mastectomy (n=2) or a prophylactic oophorectomy (n=8). There was no report of a bilateral prophylactic mastectomy being performed.

Conclusion

Although BRCA1/2 mutation carriers for high-risk patients with hereditary breast cancer have been identified in Korea, practice and management for cancer prevention does not seem to be actively performed. The Korean Hereditary Breast Cancer (KOHBRA) Study will serve to establish the Korean guidelines of evidence-based clinical practice for hereditary breast cancer.

Keywords: Hereditary breast cancer, Practice patterns for management, Questionnaire

Figures and Tables

Table 1

Characteristics of respondents

Table 2

Practice patterns of respondents related to genetic screening

Table 3

Indications of BRCA1/2 test in breast cancer patients

Table 4

Mutation carriers previously-identified

Table 5

Management patterns of BRCA mutation carriers

^*magnetic resonance image; ^†prophylactic mastectomy.

Appendix

Appendix 1.

Questionnaire for checking breast cancer genetics knowledge

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