The Importance of Continued Vigilance after Risk-Reducing Mastectomy in BRCA Carriers: A Case Report.

Risk-reducing mastectomy (RRM) is safe and effective in preventing breast cancer (BC) in BRCA mutation carriers. Nipple-sparing mastectomy (NSM) has become the new standard due to better esthetic result and comparable efficacy profile. After RRM, the risk of developing BC still exists though hardly quantifiable due to few data in literature. We describe the case of a 70-year-old woman who was found to harbor a BRCA2 mutation after diagnosis of ovarian cancer (OC) in her sister, underwent prophylactic surgery for BC and OC, as per international guidelines, and 4 years after was diagnosed with BC, metastatic to the ipsilateral axillary lymph nodes. This case highlights the importance of going on with active surveillance after RRM and the need of developing dedicated protocols about follow-up and breast imaging for these patients.