Báo cáo một trường hợp hematocrit cao và kết quả xét nghiệm đông máu bất thường ở trẻ sơ sinh: Vai trò của điều chỉnh thể tích chất chống đông citrate

The management of breast cancer in individuals carrying BRCA1/2 gene mutations presents complex challenges, particularly concerning surgical strategies. The debate surrounding optimal surgical choices for these patients, weighing the risks of ipsilateral recurrence, contralateral breast cancer, and the survival benefits of prophylactic interventions, remains central to clinical decision-making. Nipple-sparing mastectomy (NSM), lauded for its superior cosmetic outcomes, has emerged as a significant option in both therapeutic and prophylactic contexts for individuals with and without BRCA mutations. This study addresses the critical need for local data on the application and effectiveness of NSM in BRCA mutation carriers in Vietnam, aiming to shed light on its safety, efficacy, and patient satisfaction.

Oncologists, breast surgeons, genetic counselors, researchers in breast cancer genetics, and healthcare policymakers interested in managing high-risk breast cancer patients, particularly those with BRCA mutations.

This study investigated the characteristics, surgical approaches, and initial outcomes of nipple-sparing mastectomy (NSM) in patients with breast cancer and/or their family members carrying BRCA1/2 or other related gene mutations at Tam Anh General Hospital, Ho Chi Minh City, from January 2023 to June 2025. The background highlights the ongoing discussion regarding surgical choices for BRCA mutation carriers, considering recurrence risks and the benefits of prophylactic mastectomy for long-term survival. The methodology involved a retrospective review of cases, focusing on epidemiological and pathological features, types of gene mutations (BRCA1, BRCA2, TP53, PALB2 were identified as most common), and the specific surgical treatments. Key findings revealed that 24 NSMs were performed on 16 patients, with a median age of 45 years. A significant proportion (87.5%) had a family history of breast or ovarian cancer. Triple-negative breast cancer was prevalent (69.2%) among those with cancer. The study observed that 56.3% of patients underwent bilateral NSMs, indicating a growing trend in the procedure's application. Importantly, histological analysis of prophylactic mastectomy specimens showed no evidence of atypical hyperplasia, carcinoma in situ, or invasive carcinoma, suggesting a low probability of nipple involvement by premalignant or malignant lesions. The conclusions underscore that NSM with immediate breast reconstruction is a suitable and oncologically safe option for selected BRCA mutation carriers, offering enhanced patient satisfaction with cosmetic results. This research provides valuable local data supporting the judicious use of prophylactic mastectomy and therapeutic NSM in this high-risk population.