TUESDAY, August 31 () — Women who have gene mutations that increase the risk of breast and ovarian cancer can substantially reduce their chances of developing—and dying from—those cancers if they have their breasts or ovaries removed preemptively, according to a new study.
The study, which appears in the Journal of the American Medical Association, confirms that preventive mastectomy and ovary removal can slash the risk of cancer in women carrying the BRCA-1 or BRCA-2 gene mutations, and it suggests that surgery is more effective than rigorous screening at preventing future cancer.
Researchers at 22 cancer centers in the U.S. and Europe followed nearly 2,500 women with BRCA gene mutations for about four years. None of the women who underwent preventive mastectomy developed breast cancer during the study, whereas 7% of the women who opted against the surgery did. (The women who did not have surgery were put on an intensive screening schedule.)
Meanwhile, just 1% of women who had at least one ovary and fallopian tube removed (a procedure known as salpingo-oophorectomy) were diagnosed with ovarian cancer, compared to 6% of women who didn’t have the surgery. The rate of breast-cancer diagnosis was also lower in women who underwent salpingo-oophorectomy (11%) than in those who did not (19%).
In addition, the women who had an ovary and fallopian tube removed cut their risk of dying from ovarian and breast cancer by 79% and 56%, respectively.
The findings confirm “an incredibly important endpoint,” says Claudine Issacs, MD, one of the study researchers and the medical director of cancer assessment and risk evaluation at Georgetown Lombardi Comprehensive Cancer Center, in Washington, D.C. “If you have this preventive surgery, it not only decreases the risk of disease but also significantly decreases the risk of death, which is [the] most important thing you’re trying to do.”
Between 56% and 84% of women with a BRCA mutation will develop breast cancer in their lifetime, while 36% to 63% of women with the BRCA-1 mutation and 10% to 27% of women with the BRCA-2 mutation will develop ovarian cancer, according to estimates cited in the study.