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Prophylactic Surgery Lowers Breast Cancer Risk in BRCA Mutation Carriers

Posted Sep 01 2010 8:06am
Breast cancer development is a complex process that involves many factors.  One such factor involves mutations to the BRCA1 and BRCA2 genes.  Women who carry either the BRCA1 or BRCA2 gene mutations are at about a 60-80% increased risk for breast cancer.  Women with BRCA gene mutations are often faced with the tremendously difficult decision of whether to undergo a mastectomy in order to reduce their risk for developing breast cancer.  Previous research has reported that prophylactic mastectomy reduces breast cancer risk in women with BRCA gene mutations; however, it has been unclear whether such breast cancer prevention surgery effects BRCA1 and BRCA2 gene mutations carriers differently and the impact of such surgery on survival benefits.

A new cancer study ( free to read/download ), published today in the Journal of the American Medical Association explored these questions and more.  Investigators studied nearly 2,500 women who carried the BRCA1 or BRCA2 mutations to determine the risk-reducing benefits of breast removal and ovary removal.  The women in the study were followed for about 4 years.  A number of important finding were reported; some of them are outlined below
  • No breast cancers were detected in the group of women who elected to undergo prophylactic mastectomy, while 7% (98 women) of the women in the group that did not have a prophylactic mastectomy developed breast cancer.
  • Among women who chose to have their ovaries removed, risk for a first diagnosis of breast cancer was reduced by 37% in BRCA1 gene mutation carriers and by 64% in BRCA2 gene mutation carriers.  This benefit appeared to only be among women who had elected to have their ovaries removed before 50 years of age.
  • In women carrying the BRCA gene mutations who had a previous breast cancer, having their ovaries removed did not reduce their risk of developing a second primary breast cancer.
  • Women with BRCA gene mutations who elected to have their ovaries removed to reduce their cancer risk also were had a 60% lower risk for all-cause morality, 56% lower risk of death due to breast cancer and about an 80% lower risk of death due to ovarian cancer.
You can learn more about this study by watching The JAMA Report video .

This study confirms previous smaller studies by showing that breast cancer prevention mastectomy substantially reduced breast cancer risk.  While this might seem like an obvious statement, prophylactic mastectomy does not remove all breast cancer risk because some tumor cells can be left behind; however, knowing that breast cancer risk can be reduced for women carrying the BRCA gene mutations by this surgery is important. In addition, to the breast cancer risk reduction benefits observed, this study appears to be one of the first to show that the risk of dying from breast or ovarian cancer can be dramatically reduced in women with the BRCA gene mutations by having their ovaries removed.  Overall this is important information for women carrying either of the BRCA gene mutations and enhances our breast cancer awareness.  Knowing both the risks and benefits associated with this approach to reducing breast cancer risk is vital to women faced with making these kinds of decisions.

Enhancing breast cancer awareness is a vital part of our fight against breast cancer.  You can learn more about diet and lifestyle choices you can make that will help reduce your personal risk of breast cancer by reading my FREE book Fight Now: Eat & Live Proactively Against Breast Cancer .
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