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ICARE Newsletter Summer 2012

Ask the Expert: What are the recommendations for screening following prophylactic surgeries?

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The following questions were addressed by Drs. Pal and Lancaster at the Moffitt Cancer Center:

Q. What are the recommendations for screening following prophylactic surgeries?

A. In BRCA mutation carriers, bilateral prophylactic mastectomy reduces the risk of breast cancer by over 90%. It essentially lowers the risk of breast cancer to below that of the general population. Similarly, in those with bilateral prophylactic salpingooophorectomy (BPSO), risk of ovarian cancer is reduced by 80% or more. At the Moffitt Cancer Center, BRCA mutation carriers who have undergone a bilateral mastectomy are screened through clinical exams, and no imaging studies are routinely recommended. In those with BPSO, CA-125 levels (measured through a blood test) are ordered yearly, and no transvaginal ultrasounds are routinely recommended. These recommendations are based on clinical judgment of our team, and there is no data at this time to determine the necessity of this (or any) screening regimen in these individuals following prophylactic surgery.

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