Practice patterns of surgeons for the management of hereditary breast cancer in Korea.

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 email 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 highrisk 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.