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August 31, 2010

A new study confirms the survival benefit of preemptive removal of the breasts or ovaries for women who have one of two common breast cancer genes, The Los Angeles Times reports.

The surgery can greatly reduce the risk of contracting cancer and dying, even if the patient is already diagnosed with cancer.

This study published Tuesday in the Journal of American Medical Association, is the largest medical investigation to date on the subject and the first that differentiates the benefits of the surgeries based on which gene a woman has and whether or not she already has cancer, The Los Angeles Times reports.

The risk of ovarian cancer can be squelched by removing the ovaries and ovarian tubes. This surgery also reduces the risk of breast cancer by nearly 70 percent because estrogen, produced in the ovaries, feeds the cancerous cells. Removal of the breast can reduces breast cancer by about 85 percent. Either surgery reduces the risk of dying by two-thirds.

This study show that these operations give women with these genes a better chance at surviving. This can help women forced to make a tough choice make a better and more informed decision, Dr. Kenneth Offit, chief of the clinical genetics service at Memorial Sloan-Kettering Cancer Center in New York, who also was not involved in the study, told The Los Angeles Times.

Women who have either BRCA₁ or BRCA₂ gene have a total lifetime risk of 54-84 percent chance of developing breast cancer and a 23-45 percent chance of getting ovarian cancer.

Supported by this new study, most physicians now recommend the removal of the breast to be considered after these genes are discovered. For those who reject the surgery, the alternative is more intense screening with mammograms or an MRI every six months. The BRCA₁ gene is associated with a more aggressive, fast growing form of breast cancer and a higher risk of ovarian cancer.

For BRCA carriers, once women are done having children, most doctors recommend the removal of the ovaries and ovarian tubes. There is no alternative that offers such a great survival benefit. The greatest risk to this preventative procedure is surgically induced menopause.

This study led by Dr. Timothy R. Rebbeck and Dr. Susan M. Domchek at the University of Pennsylvania School of Medicine followed 2,482 women who had been diagnosed as BRCA carriers between 1974 and 2008. About 10 percent chose to remove their breasts and about 40 percent their ovaries. Some overlapped and more than half had neither procedure, The Los Angeles Timesreports.

Compared to those who underwent surgery to remove their ovaries, the women who opted out of surgery were six times more likely to develop ovarian cancer and were three times more likely to die. Now for women who have either BRCA, there is a proven strategy that can help save their life.

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