Patients with BRCA mutations are often faced with a difficult decision as to whether and when to perform risk-reducing salpingo-oophorectomy (SO). The combination of SO with mastectomy and/or breast reconstructive surgery is an attractive option. The purpose of this study is to assess the postoperative complication rates of SO performed alone compared to in combination with breast surgery.METHODS:
A retrospective chart review was performed to identify patients who had both risk-reducing SO and breast surgery performed between 2010 and 2014. We identified 48 patient: 22 had breast and gynecologic surgeries performed simultaneously while 26 had SO performed separately, with or without hysterectomy. All gynecologic surgeries were performed by physicians within the same Gynecologic Oncology practice. Statistical analysis with t test and P values were calculated using GraphPad and Excel software.RESULTS:
We found that of the patients who underwent simultaneous surgeries, 59% had hysterectomy at time of SO compared to 50% of those who underwent separate gynecologic surgery. The majority of gynecologic procedures were performed laparoscopically for both groups, however for the SO separate group, 42% of the pelvic surgeries were performed robotically. Length of stay was slightly longer for the combined breast and pelvic surgeries (mean 3.2 vs 1.7 days) and estimated blood loss was higher (mean 234 vs 101 mL), however postoperative complication rates were similar.CONCLUSION:
Combined breast and pelvic surgery is a viable option for risk-reducing salpingo-oophorectomy in BRCA mutation carrier patients.