Many at High Risk of Breast Cancer Choose Surgery

Women's choice to undergo preventative surgery dependent on risk level, age and time

FRIDAY, Aug. 7 (HealthDay News) -- Many women at high risk for breast or ovarian cancer opt to surgically remove these organs to decrease their risk, although this is dependent on age, time and risk, according to a study in the August Cancer Epidemiology, Biomarkers & Prevention.

D. Gareth R. Evans, M.D., of St. Mary's Hospital in Manchester, U.K., and colleagues report on the trend in use of risk-reducing surgery for women identified to be at high risk of breast or ovarian cancer. They studied patients who were found to carry a BRCA1/2 genetic mutation. A separate group of unaffected patients were identified who had a greater than 25 percent lifetime risk of developing either cancer, but did not have a BRCA1/2 mutation.

Of those women identified to carry a BRCA1/2 mutation, the researchers found that 40 percent chose to undergo a bilateral risk-reducing mastectomy and 45 percent underwent a bilateral risk-reducing salpingo-oophorectomy. Choice of a preventative mastectomy was significantly associated with degree of lifetime risk and age, but continued for several years. For women at increased risk without a BRCA1/2 mutation, the likelihood of undergoing a mastectomy was dependent on their risk level -- 1.8 percent of women at 25 to 32 percent risk underwent mastectomy compared with 6.4 percent of women at 40 to 45 percent risk.

"To truly assess the uptake of risk-reducing surgery, longer-term follow-up is necessary particularly in younger women who are likely to delay bilateral risk-reducing salpingo oophorectomy. Careful risk counseling does seem to influence women's decisions for surgery, although the effect is not immediate," the authors write.

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Lisa Cockrell

Lisa Cockrell

Published on August 07, 2009

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