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Author response: Enhancing methodological rigour in prepectoral breast reconstruction studies
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Raafat Gendy
Correspondence to: Raafat Gendy (email: raafat.gendy1@nhs.net)
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Enhancing methodological rigor in prepectoral breast reconstruction studies
Janhavi Venkataraman, Kefah Mokbel
Correspondence to: Janhavi Venkataraman (email: Janhavi.Venkakataraman@hcahealthcare.co.uk; janhavivraman@gmail.com)
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Guest post: Mental health and BRCA
Grace Brough, Douglas Macmillan, Kristjan Asgeirsson, and Emma Wilson Division of Epidemiology and Public Health, University of Nottingham Nottingham Breast Institute, Nottingham University Hospitals NHS Trust
Exploring psychological consequences for BRCA+ women in the post-Covid era
Whilst the global female population has a 12.5% overall lifetime risk of developing breast cancer and a 1.3% risk of ovarian cancer (Howlader et al), the risk for those with a pathogenic BRCA1 or BRCA2 mutation is 60-70% and 10-20% respectively (van Egdom et al). BRCA1 mutation carriers have a particularly high incidence of triple-negative breast cancer (TNBC) (Greenup et al) for which treatment options are more limited and always include chemotherapy (Bianchini et al; Collignon et al).
In the NHS, asymptomatic women with at least a 10% estimated chance of having a BRCA mutation are offered testing (NICE). Knowing you are at high risk of breast cancer and the increased likelihood of TNBC is a well-documented cause of anxiety (Wenzel et al) and many women describe having a BRCA gene mutation as living with a ‘ticking time bomb’. Bilateral mastectomy with or without reconstruction is the only proven method of drastically decreasing risk and can improve quality of life (McCarthy et al) and decrease anxiety (Rebbeck et al) for correctly selected cases, despite its potential negative outcomes (Gahm et al).