Pathogenic germline CDH1 mutation confers high risk for developing diffuse gastric and lobular breast cancers in asymptomatic carriers. In these individuals, the estimated gastric cancer risk at 80 years of age is up to 70% for males and 56% for females. Due to this high‐risk predisposition, prophylactic total gastrectomy is considered a unique life‐saving approach in germline CDH1 carriers, as endoscopy often fails to detect early stage diffuse gastric carcinoma. However, surgical indication is controversial in some clinical contexts, with possible contraindications. This review discusses points against and in favor of a more aggressive surgical approach for consideration during the decision‐making process.

中文翻译：

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种系 CDH1 变异携带者预防性全胃切除术的注意事项

致病种系CDH1突变使无症状携带者患弥漫性胃癌和小叶乳腺癌的风险很高。在这些人中，预计 80 岁时患胃癌的风险男性高达 70%，女性高达 56%。由于这种高风险倾向，预防性全胃切除术被认为是生殖细胞中独特的挽救生命的方法CDH1携带者，因为内窥镜检查通常无法发现早期弥漫性胃癌。然而，手术适应症在某些临床情况下存在争议，可能存在禁忌症。本综述讨论了反对和支持更积极的手术方法的观点，供决策过程中考虑。