Women with BRCA mutation most likely to undergo mastectomy

Women at increased risk for breast cancer because of the genetic BRCA mutations are more likely to think a prophylactic mastectomy is the best way to reduce their risk for the disease, compared to other women who are at high risk, according to researchers at The University of Texas M. D. Anderson Cancer Center.

The study, published in the most recent issue of Cancer, also finds that the emotional worry was a strong factor leading women ? both BRCA mutation carriers and others at high risk for the disease ? to opt for the surgery.

It’s estimated that .1 to .2 percent of the general population carry either the BRCA 1 or 2 mutation, both of which are associated with an increased risk of breast and/or ovarian cancer.

For those with the BRCA1 mutation, their lifetime risk of developing breast cancer is 47-66 percent, with some estimates even higher; those with BRCA2 have a lifetime risk of 40-57 percent.

Women are referred to genetic counseling because of a personal diagnosis of breast cancer at a very young age, or a strong family history of the breast and/or ovarian, explained Jennifer Litton, M.D., assistant professor in M. D. Anderson’s Department of Breast Medical Oncology.

“Women who are even suspected to have a BRCA mutation are highly motivated and need to make important decisions regarding their treatment options, even if they don’t have cancer,” said Litton the study’s senior author.

“With the study, we wanted to determine the reasons why women make different choices in either screening – including breast-self exams, mammograms, or MRIs ? or prophylactic measures, such as medications like Tamoxifen or surgeries.”

“For clinicians, this study shows that when we’re counseling women about prophylactic mastectomies, we need to not just talk about the surgery, but understand their lifestyles,” said Litton. “When the worry of developing cancer is interfering with a patient’s day-to-day activities, then their quality of life is impacted. These women with a high risk of developing breast cancer may find that despite the surgery and subsequent recuperation, a prophylactic mastectomy improves their quality of life.”

Women at highest risk need to ask themselves some very important, personal questions that only they have the answers to, said Litton.

The study was funded in part by the Nellie B. Connally Breast Cancer Research Fund and a grant from the National Institutes of Health.

Source: University of Texas M. D. Anderson Cancer Center, USA



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