Preventive Mastectomies Lower Cancer Risk

No breast cancer diagnoses in high-risk patients who had procedure

(RxWiki News) Women at high risk of developing breast or ovarian cancer significantly reduce their odds of developing the diseases with major preventive surgeries to remove the breasts, ovaries and fallopian tubes, a new study indicates. Women with the specific genetic mutations BRCA1 and BRCA2 are at a proven higher risk of developing breast and ovarian cancers, prompting some to take the risk of elective surgery. (Almost 85 percent of women who carry either gene mutation will go on to develop breast cancer and about 63 percent of these carriers will develop ovarian cancer.)


The study, published this month in the Journal of the American Medical Association, followed nearly 2,500 women with the BRCA1 or BRCA2 genetic mutations from 1974 until 2008 at 22 centers in Europe and North America. Of the 247 women who chose double mastectomies as a preventative measure, no breast cancers were diagnosed, while one in 13 of the 1,372 patients – about 7 percent – who elected not to have surgery were diagnosed with breast cancer. 

Researcher Gail Tomlinson, M.D., Ph.D., interim director of the Greehey Children's Cancer Research Institute at The University of Texas Health Science Center at San Antonio, said that removing organs for cancer risk has been a controversial subject, although researchers have believed in the measure’s effectiveness for 15 years. She said the idea seems jarring unless one considers that women with the genetic markers for breast or ovarian cancer continually see family members suffer or die from the disease.  

“This is a compromise women are willing to accept and their husbands are willing to accept,” Tomlinson said, but added quality-of-life issues after radical surgery should be addressed and weighed by women considering the measure.  

Women who elected to have their ovaries and fallopian tubes removed also showed less risk of developing cancer, including women who had previously been diagnosed with breast cancer.  About 1 percent of women who had one ovary along with their fallopian tubes removed – a procedure known as salpingo-oophorectomy – developed cancer, while 6 percent of those who did not have the surgery developed cancer.

A fellow researcher on the panel, Dr. Claudine Isaacs said the preventive surgeries not only decreases the risk of disease, they also significantly decrease the risk of death, “which is [the] most important thing you’re trying to do.” 

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September 15, 2010