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qui peut influencer le choix de la prise en charge controlatérale) n'est pas très différent en cas de mutation BRCA1/2 et dans les formes sporadiques [86,91,92]. Le recul est cependant souvent limité à quelques années, la localisation de la récidive (dans le même quadrant ou non) est rarement signifiée et l'influence des traitements systémiques n'est pas prise en compte ,
augmentation du risque de cancer controlatéral, en cas de mutation BRCA, est acquise (niveau de preuve 2), le bénéfice éventuel sur la survie de la chirurgie préventive ou d'un diagnostic précoce du cancer controlatéral n'est pas documenté ,
ces études rétrospectives ne prennent pas en considération, du fait de la petite taille de l'échantillon, le gène en cause (BRCA1 ou BRCA2) qui n'est probablement pas ,
-la perception de la maladie à travers le vécu familial (nombre de cas de cancers du sein/ovaire, proximité des personnes touchées, nombre de décès par cancer dans la famille) -la présentation par les soignants des risques et des options ,
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une mutation ayant un antécédent de cancer du sein traité Si les experts sont unanimes à recommander de faire le maximum pour identifier la mutation avant le diagnostic de cancer [109], de nombreuses patientes auront leur diagnostic de mutation en même temps ou après le cancer du sein. Actuellement, la consultation génétique, avec ses possibles retombées sur le traitement local ,
étude s'intéressant spécifiquement aux suites et à la morbidité spécifique de la chirurgie prophylactique chez les patientes ayant déjà eu un cancer du sein Une seule étude [18] relève des taux de complications comparables après reconstruction chez des patientes indemnes ou ayant eu un cancer avec un taux global de complications et effets secondaires de 50 % dont 70 % avaient nécessité une réintervention. À noter dans cette étude, pour les complications précoces (infection, nécrose, saignement, luxation de prothèse), un taux d'infection plus élevé (26 vs 13 %) dans le groupe des patientes ayant déjà eu un cancer ,
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