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Researchers identify risk factors for contralateral breast cancer
Date:1/26/2009

cancer identified at surgery, and 82 patients had abnormal cells (atypical ductal hyperplasia, atypical lobular hyperplasia and lobular carcinoma in situ) that indicate a moderate to high-risk for breast cancer development in the contralateral breast found at the time of surgery.

Further analysis of the patients with contralateral breast cancer revealed that a five-year Gail risk of 1.67 percent or greater; an invasive lobular histology; and multiple tumors in the original breast were all strong predictors for contralateral breast cancer. Patient race, estrogen receptor status and progesterone receptor status were not associated with increased risk.

"We went from having very little information on the benefit of this procedure for individual patients to identifying three independent and significant risk factors," Hunt said. "Each provides valuable insight into how likely a woman is to develop the disease in her other breast and enables physicians to make an educated recommendation if a patient will potentially benefit from CPM."

The Gail model, typically used for patients without breast cancer, evaluates factors such age, age at menarche, number and findings of previous breast biopsies, age at first live birth and number of first-degree relatives with breast cancer, has been validated in several studies to calculate the risk of developing an invasive breast cancer over the next five years. The five-year risk of 1.67 percent is traditionally used as the cutoff point for the definition of "high risk."

"We've always known contralateral breast cancer risk is not the same for all women and it is unnecessary to perform preventive mastectomies routinely. As we begin to clarify the specific risk factors, the number of women undergoing CPM may decrease and those with a low to moderate-risk may be more open to less extreme options for risk reduction, such as hormonal therapy and newer agents for prevention of breast cancer."


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Contact: Lindsay Anderson
lindsay.anderson@gabbe.com
212-220-4444
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert

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