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Second breast cancer may be greater than thought for high-risk women without BRCA mutations
Date:5/4/2008

utation (group 2). The women in group 2 already had known malignancies and had preoperative genetic testing. All the women opted to have a mastectomy to remove their affected breast (group 2) or surgery to remove both breasts (both groups). They all had both breasts removed, but in Group 2 they all had a unilateral prophylactic mastectomy.

"We examined the rate of occult malignancies in both these groups of women in the prophylactic mastectomy specimens," Willey explains. "What we found was interesting. There was a higher than expected presence of disease in the women who did not test positive for a BRCA mutation.

"The higher rate of occult cancers in group 2 may be because they all had contralateral known malignancies, but this study supports the use of prophylactic mastectomy as an option for these women as it is for those who have a BRCA mutation," says Willey.

Willey notes that additional studies should address the role of sentinel node biopsy for high-risk women who are receiving prophylactic mastectomy.

"We need a better understanding of the incidence of cancer in these women to help determine the need for sentinel lymph node biopsy at the time of mastectomy, even in patients in which mastectomy is entirely prophylactic," says Willey. "There are risks and serious side effects involved with sentinel node biopsy. We will need to find a balance between offering appropriate care and over-treating these women.

"The trend in this study highlights the importance of counseling all high-risk women about their risk of developing another cancer when considering surgical options including sentinel node biopsy."


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Contact: Karen Mallet
km463@georgetown.edu
414-312-7085
Georgetown University Medical Center
Source:Eurekalert

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