Techniques and complications of non-genetic risk reducing mastectomies: Guidelines of the National College of French Gynecologists and Obstetricians (CNGOF)

Objective

Based on an updated review of the international literature covering the different surgical techniques and complications of risk reducing mastectomies (RRM) in non-genetic context, the Commission of Senology of the College National des Gynécologues et Obstétriciens Français (CNGOF) aimed to establish guidelines on techniques to be chosen and their implementation.

Design

The CNGOF Commission of Senology, composed of 24 experts, developed these guidelines. A policy of declaration and monitoring of links of interest was applied throughout the process of making the recommendations. Similarly, the development of these recommendations did not benefit from any funding from a company marketing a health product. The Commission of Senology adhered to and followed the AGREE II (Advancing guideline development, reporting and evaluation in healthcare) criteria and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method to assess the quality of the evidence on which the recommendations were based. The potential drawbacks of making recommendations in the presence of poor quality or insufficient evidence were highlighted.

Methods

The Commission of Senology considered 6 questions in 4 thematic areas, focusing on oncologic safety, risk of complications, aesthetic satisfaction and psychological impact, and preoperative modalities.

Results

The application of the GRADE method resulted in 7 recommendations, 6 with a high level of evidence (GRADE 1+/-) and 1 with a low level of evidence (GRADE 2+/-).

Conclusion

There was significant agreement among the Commission of Senology members on recommendations for preferred surgical techniques and practical implementation.