J Breast Cancer.  2010 Dec;13(4):437-442. 10.4048/jbc.2010.13.4.437.

Single-Port Access Laparoscopic Prophylactic Bilateral Salpingo-Oophorectomy in BRCA-Positive Breast Cancer Patient: A Case Report

• Kim TJ
• Choi MY
• Lee SK
• Hur SM
• Kim S
• Koo MY
• Bae SY
• Cho DH
• Choe JH
• Kim JH
• Kim JS
• Kim BG
• Bae DS
• Lee JE
• Nam SJ
• Yang JH

• KMID: 2286533
• DOI: http://doi.org/10.4048/jbc.2010.13.4.437

Abstract

For women with a BRCA 1/2 mutation, prophylactic bilateral salpingo-oophorectomy (BSO) is known to reduce the risk of developing both ovarian and breast cancer. The increasing interest in hereditary breast cancer has recently resulted in frequent genetic testing for high-risk patients. Since breast surgeons frequently encounter BRCA-positive breast cancer patients or carriers in the outpatient clinic, it is a prerequisite that the decision of the patients and doctors should be based on a thorough understanding of the objective risk, the medical assessment and the various treatment options, including surgery and anti-cancer therapy. The risk for the ovarian cancer also makes up an important part of genetic counseling; therefore, the breast surgeons should be well aware of this. This report presents the first experience with performing single-port access laparoscopic prophylactic BSO for a BRCA-positive breast cancer patient, and this procedure was technically feasible and the patient had minimal scar. However, a future investigation is needed to properly assess the cosmetic outcome in this approach.

Keyword

BRCA2 gene mutation; Breast neoplasms; Hereditary; Laparoscopy; Salpingo-ovariectomy

MeSH Terms

Ambulatory Care Facilities
Breast
Breast Neoplasms
Cicatrix
Cosmetics
Female
Genetic Testing
Humans
Laparoscopy
Ovarian Neoplasms
Cosmetics

Figure

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  Figure 1 Family pedigree. Patient's one sister had breast cancer. Patient has BRCA2 mutation. Arrow indicates the patient.

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  Figure 2 Homemade port placement for single-port access laparoscopic surgery.

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  Figure 3 (A) Normal-looking ovaries and fallopian tubes. (B) Immediate picture after bilateral salpingo-oophorectomy by bipolar electrosurgeries.

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  Figure 4 Specimen retrieval using EndoPouch® through an opening.

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  Figure 5 Immediate umbilical wound of 1.5 cm size.

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