Navigation Links
Women with BRCA mutation, or worry, most likely to undergo prophylactic mastectomy

HOUSTON ― Women at increased risk for breast cancer because of the genetic BRCA mutations are more likely to think a prophylactic mastectomy is the best way to reduce their risk for the disease, compared to other women who are at high risk, according to researchers at The University of Texas M. D. Anderson Cancer Center.

The study, published in the most recent issue of Cancer, also finds that the emotional worry was a strong factor leading women both BRCA mutation carriers and others at high risk for the disease to opt for the surgery.

It's estimated that .1 to .2 percent of the general population carry either the BRCA 1 or 2 mutation, both of which are associated with an increased risk of breast and/or ovarian cancer. For those with the BRCA1 mutation, their lifetime risk of developing breast cancer is 47-66 percent, with some estimates even higher; those with BRCA2 have a lifetime risk of 40-57 percent.

Women are referred to genetic counseling because of a personal diagnosis of breast cancer at a very young age, or a strong family history of the breast and/or ovarian, explained Jennifer Litton, M.D., assistant professor in M. D. Anderson's Department of Breast Medical Oncology.

"Women who are even suspected to have a BRCA mutation are highly motivated and need to make important decisions regarding their treatment options, even if they don't have cancer," said Litton the study's senior author. "With the study, we wanted to determine the reasons why women make different choices in either screening - including breast-self exams, mammograms, or MRIs or prophylactic measures, such as medications like Tamoxifen or surgeries."

In conducting the study, the researchers sent surveys to 540 women who received genetic counseling and were screened for the BRCA mutations at M. D. Anderson between 1997 and 2005. Of those surveys, 312 (58 percent) were returned: 217 (70 percent) had breast cancer and 86 (28 percent) tested positive for the BRCA1 or 2 mutation.

In the surveys, patients were asked questions regarding their fear of developing the disease, as well as their feelings on: the screening techniques mammograms and breast-self exams; the drug Tamoxifen and its known side effects, and prophylactic surgeries.

Regarding mammograms and self breast exams, the study found little difference between the BRCA positive and negative cohorts. Neither group felt that mammograms were too difficult to get because of discomfort, nor did either report being too embarrassed to perform breast-self exams. In addition, there was no statistical difference in the two groups' feelings toward Tamoxifen: 37.9 percent of the BRCA positive patients and 46.5 percent of the BRCA negative patients felt that the concerns associated with the drug outweighed its benefits for reducing risk of developing breast cancer.

In evaluating the response to questions regarding prophylactic mastectomies, the researchers began to see significant differences between the two groups, and "worry" as a recurring concern.

When comparing BRCA positive to BRCA negative cohorts: 70 percent versus 40 percent respectively felt that prophylactic mastectomies were the most effective way to reduce their risk of developing the disease; 36.1 percent versus 40.5 percent respectively felt it was too drastic of a measure to prevent breast cancer; 23.9 percent versus 12.5 percent respectively had difficulty in deciding between surgery and screening.

Regarding their degree of worry, 64.7 percent of BRCA positive patients thought a prophylactic mastectomy was the only way to reduce their fear of the disease, compared to 34.4 percent of BRCA negative patients.

When combining both groups, after excluding women with bilateral breast cancer, 81 percent who thought surgery was their best way to reduce their risk, and 84 percent of those who felt that it was their best way to reduce their worry ultimately underwent the procedure. In contrast, 19.1 percent of those who did not feel that the surgery was the best way to reduce their risk and 15.8 percent of women who did not think it was their only way to decrease their worry opted to have a prophylactic mastectomy.

In her clinical experience, Litton has seen many high-risk women, particularly those who test positive for the BRCA 1 or 2 mutation, that initially opt for intensive screening, but after several mammograms, MRIs and biopsies, eventually decide to have a prophylactic mastectomy.

"For clinicians, this study shows that when we're counseling women about prophylactic mastectomies, we need to not just talk about the surgery, but understand their lifestyles," said Litton. "When the worry of developing cancer is interfering with a patient's day-to-day activities, then their quality of life is impacted. These women with a high risk of developing breast cancer may find that despite the surgery and subsequent recuperation, a prophylactic mastectomy improves their quality of life."

Women at highest risk need to ask themselves some very important, personal questions that only they have the answers to, said Litton.

"When making such a personal decision, these women at highest risk need to ask themselves about how they feel about their breast as far as their body image, sexuality, relationship with and support of their partner, as well as their concern for breast cancer. If that worry comes in the way of their day-to-day activities, it should be taken into consideration as part of the patient's decision-making process."

Litton cautioned that the results should not be generalized for the majority of the breast cancer population. Additionally, high risk women, of course, should also be counseled on the risk associated with surgery.

As a follow up to this study, Litton plans to conduct a study with high-risk women of child-bearing age pre- and post-genetic counseling to determine their degree worry, their guilt of possibly passing on the gene to their offspring and thoughts on pre-gestational diagnosis.


Contact: Laura Sussman
University of Texas M. D. Anderson Cancer Center

Related medicine news :

1. Both Latino and non-Latino women likely to accept HPV vaccination for selves and children
2. Clinical trial finds microbicide promising as HIV prevention method for women
3. Stress May Raise Diabetes Risk for Obese Black Women
4. Bad Marriages Harder on Womens Health
5. Mortality risk greater for elderly women who nap daily
6. a la mode Bra Fitting Specialty Boutique Now Has Trained Fitters and Products for Women Who Are Post Op Mastectomy or Lumpectomy
7. Teeth Whitening Ranks Most Desired Cosmetic Procedure For Women. Hollywood Sexy Smile Whitens Teeth At Home 8 Shades Without The Dentist.
8. Sonohysterography is an alternative diagnostic tool for women with adenomyosis
9. AFRAID TO GO HOME, A Novel About Violence Against Women, Released By Tristan/Isolde Publishing
10. Video: Avon Commits Over $1.75 Million for New Partnerships to End Violence Against Women
11. Singapore Premier Women's Hospital Offers Contactless Surgery for Uterine Fibroids
Post Your Comments:
(Date:11/27/2015)... , ... November 27, 2015 , ... MPWH, the No.1 Herpes-only dating community in the ... Table 1-1 ). More than 3.7 billion people under the age of 50 ... (HSV-1), according to WHO's first global estimates of HSV-1 infection . , "The data ...
(Date:11/27/2015)... ... November 27, 2015 , ... A simply groundbreaking television series, "Voices ... show that delves into an array of issues that are presently affecting Americans. Dedicated ... open dialogue, this show is changing the subjects consumers focus on, one episode at ...
(Date:11/27/2015)... Los Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... the Commission on Accreditation of Allied Health Education Programs (CAAHEP) awarded accreditation to its ... exclusive list of CAAHEP accredited colleges, as only one of twelve colleges and universities ...
(Date:11/27/2015)... ... November 27, 2015 , ... Avid collector, Andrew Hawley from Vintage ... style concert posters. This is one of Joplin's most famous and beautiful concert posters. ... University of Michigan in Ann Arbor. The According to Hawley, "It is hard to ...
(Date:11/26/2015)... (PRWEB) , ... November 26, 2015 , ... Inevitably when ... Many customers choose to buy during the Black Friday and Cyber Monday ... don’t need to search the Internet high and low to find the best massage ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , November 26, 2015 /PRNewswire/ ... announced the addition of the  "2016 ... the Global Cell Surface Testing Market: ... report to their offering.  --> ... addition of the  "2016 Future Horizons ...
(Date:11/26/2015)... , November 26, 2015 /PRNewswire/ ... --> adds "Global ... and "Investigation Report on China Repaglinide ... 2021 forecasts data and information to ... . --> ...
(Date:11/25/2015)... DUBLIN , Nov. 25, 2015 /PRNewswire/ ... announced the addition of the "Global ... to their offering. --> ... "Global Brain Monitoring Devices Market 2015-2019" ... Research and Markets ( ) ...
Breaking Medicine Technology: