Date of Award

5-2022

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Mindy Staveteig

Keywords

BRCA mutations; Breast Cancer; Mastectomy; Breast Conserving Therapy; Surgical management; Early-Stage Breast Cancer

Abstract

In the United States, breast cancer is the second most common cancer, represents 30% of total cancer cases and 14% of deaths in the United States in 2019. BRCA1 and BRCA2 are genetic mutations that increase the likelihood of developing breast cancer by 57% and 49%, respectfully. Several surgical options are available for those with newly diagnosed early-stage breast cancer. The purpose of this systemic literature review is to evaluation the safety and efficacy of breast conserving therapy versus mastectomy for surgical intervention of early-stage breast cancer patients and evaluate if possessing a BRCA positive mutation changes the recommendation for surgical interventions. In this review, PubMed was searched with a variety of key terms used. 22 sources were selected for literary review that were published after 2001, peer reviewed, and included randomized control trials, systematic reviews, and meta-analyses. The data concludes to breast conserving therapy and mastectomy being effective treatments for those with early-stage breast cancers, although research is conflicted. There were no studies suggesting either treatment was harmful to the patient, although surgical risks are involved. When evaluating for BRCA positive status, both breast conserving therapy and mastectomy appear to be effective treatments. BRCA positive patients who undergo breast conserving therapy carry a significant risk for ipsilateral and contralateral breast cancer years after diagnosis. More research needs to be done to come to a more concise conclusion on whether breast conserving therapy or mastectomy is the preferred surgical treatment and if recommendations change based on BRCA status.

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