{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:43:33Z","timestamp":1760233413369,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Cancer survivors harboring inherited pathogenic variants in the breast cancer (BC) susceptibility genes BRCA1 or BRCA2 are at increased risk of ovarian cancer (OC) and also of contralateral BC. For these women, risk-reducing surgery (RRS) may contribute to risk management. However, women with locally advanced or metastatic breast cancer (ABC) were excluded from clinical trials evaluating the benefit of these procedures in the BRCA1\/2 carriers, and thus, current guidelines do not recommend RRS in this specific setting. Although ABC remains an incurable disease, recent advances in treatment have led to increased survival, which, together with improvement in RRS techniques, raise questions about the potential role of RRS in the management of BRCA1\/2 ABC patients. When should RRS be discussed as an option for BRCA1\/2 patients diagnosed with ABC? To address this issue, we report two clinical cases that reflect new challenges in routine oncology practice. Team experience and patient motivations may shape multidisciplinary decisions in the absence of evidence-based data. A wise rationale may be the analysis of the competing risks of death by a previous ABC against risk of death by a secondary BC or OC, tailored to patient preferences.<\/jats:p>","DOI":"10.3390\/curroncol28010050","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T04:55:31Z","timestamp":1611032131000},"page":"485-490","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Challenges and Considerations on Risk-Reducing Surgery in BRCA1\/2 Patients with Advanced Breast Cancer"],"prefix":"10.3390","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-238X","authenticated-orcid":false,"given":"Leonor","family":"Vasconcelos de Matos","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Hospital S\u00e3o Francisco Xavier, Centro Hospitalar Lisboa Ocidental, 1449-005 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6655-0986","authenticated-orcid":false,"given":"Leonor","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Hospital S\u00e3o Francisco Xavier, Centro Hospitalar Lisboa Ocidental, 1449-005 Lisboa, Portugal"}]},{"given":"Pedro","family":"Louro","sequence":"additional","affiliation":[{"name":"Familial Cancer Risk Clinic, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal"},{"name":"Faculty of Health Sciences, Universidade da Beira Interior, 6200-506 Covilh\u00e3, Portugal"}]},{"given":"Ana","family":"Pl\u00e1cido","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Hospital S\u00e3o Francisco Xavier, Centro Hospitalar Lisboa Ocidental, 1449-005 Lisboa, Portugal"}]},{"given":"Manuel","family":"Barros","sequence":"additional","affiliation":[{"name":"Oncology Unit, Centro Hospitalar do Oeste, 2500-176 Caldas da Rainha, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3334-215X","authenticated-orcid":false,"given":"F\u00e1tima","family":"Vaz","sequence":"additional","affiliation":[{"name":"Familial Cancer Risk Clinic, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal"},{"name":"Medical Oncology Department, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,14]]},"reference":[{"key":"ref_1","unstructured":"Howlader, N., Noone, A., Krapcho, M., and Al, E. 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