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Sarkar P, Huffman KN, Williams T, Deol A, Zorra I, Adam T, Donaldson R, Qureshi U, Gowda K, Galiano RD. Rates of breast reconstruction uptake and attitudes toward breast cancer and survivorship among south asians: A literature review. J Surg Oncol 2024; 129:953-964. [PMID: 38247024 DOI: 10.1002/jso.27584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/13/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
Our aim in this review was to ascertain rates of breast reconstruction among South Asian patients and identify attitudes towards breast cancer, survivorship, and breast reconstruction. Mastectomy rates for South Asian patients ranged from 52% to 77% and reconstruction following mastectomy varied from 0% to 14%. A negative perception of cancer, fears of social isolation, and taboos around breasts can prevent South Asian women from receiving surgical care after a breast cancer diagnosis.
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Affiliation(s)
- Prottusha Sarkar
- Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kristin N Huffman
- Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tokoya Williams
- Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Avneet Deol
- Chicago Medical School, Rosalind Franklin University of Health & Sciences, North Chicago, Illinois, USA
| | - Isabella Zorra
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Tarifa Adam
- Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rachel Donaldson
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
| | - Umer Qureshi
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
| | - Karan Gowda
- Chicago Medical School, Rosalind Franklin University of Health & Sciences, North Chicago, Illinois, USA
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert D Galiano
- Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Mooghal M, Vohra LM, Khan W, Akbar F. Prophylactic Risk-Reducing Mastectomy (PRRM): A Set Practice or Catch-22 Situation in LMIC. A Single-Centre Prospective Cohort Study. World J Surg 2023; 47:2154-2160. [PMID: 37145137 DOI: 10.1007/s00268-023-07033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 05/06/2023]
Abstract
Background Pakistan's hereditary breast cancer has a higher-than-average prevalence. Our acceptability of prophylactic risk-reducing mastectomy (PRRM) still needs to be determined, and genetic testing still needs to be offered to all eligible. The aim is to determine the number of women presenting to our centre who availed of PRRM after positive genetic tests and the main reasons restraining them from considering PRRM.Materials and methods This study is a single-centre, prospective cohort. We collected data from 2017 to 2022 on BRCA1/2 and other (P/LP) gene-positive patients. Continuous variables are presented as means (±SD) and categorical variables in percentages, with a significant P-value of ≤ 0.05.Results Out of 477 tested individuals, only 95(20.12%) had a positive result. BRCA1/2 was positive in 70 cases, while P/LP variants were in 24 cases. Only 32.6% of eligible families underwent genetic testing, with 54.8% positivity. Altogether, 92.6% of patients had BRCA1/2-related cancers. Only 25/95(26.3%) individuals availed of PRRM, the majority had contralateral risk-reducing mastectomy 68% with a 20% reconstruction rate. The main reasons to decline PRRM were false belief of not having any disease 57.44%, followed by family/spouse pressure 51%, body appearance/societal perception, fear of complications/quality of life and financial constraints.Conclusion Genetic testing and its implications are still a grey area for LMICs, primarily due to the scarcity of centres offering genetic testing to eligible populations, followed by prevalent perceptions about prophylactic surgeries among the masses. Addressing relevant issues in LMICs is the need of time.
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Affiliation(s)
- Mehwish Mooghal
- Section Breast Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, 74800, Sindh, Pakistan.
| | - Lubna M Vohra
- Section Breast Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, 74800, Sindh, Pakistan
| | - Wajiha Khan
- Department of Surgery, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Fizza Akbar
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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