Bilateral Mastectomy Significantly Reduces Breast Cancer in BRCA1 and BRCA2 Carriers

According to results recently published in the Annals of Oncology, a bilateral mastectomy significantly reduces the risk of developing breast cancer and may potentially improve survival among women with BRCA1 and BRCA2 mutations.

Women who have the BRCA1 and/or BRCA2 genetic mutations carry a significant risk of developing breast cancer or ovarian cancer within their lifetime.

This high risk places a woman in a position in which she must decide upon her strategy to deal with a potential diagnosis of cancer.

Some women choose surveillance, or diligent screening for breast cancer on a set schedule as advised by a healthcare provider.

Other women with these mutations decide upon a much more aggressive route, including the surgical removal of both breasts (bilateral risk-reducing mastectomy, or BRRM) prior to finding any cancer. Despite undergoing BRRM, breast cancer is capable of developing in the surrounding tissues not eliminated with breast removal.

Researchers from the Netherlands recently conducted a clinical study to evaluate the effectiveness of BRRM compared to surveillance in developing breast cancer among women with BRCA1 and/or BRCA2 mutations. The data included 405 women with BRCA1 mutations and 165 with BRCA2 mutations selected from the institutional Family Cancer Clinic database. Ultimately, 156 women with BRCA1 mutations and 56 women with BRCA2 mutations underwent BRRM.

Women who underwent BRRM had over a 70% reduced risk of developing breast cancer compared with those who underwent surveillance.
The researchers concluded that “In healthy BRCA1/2 mutation carriers, BRRM when compared with surveillance reduces BC [breast cancer] risk substantially, while longer follow-up is warranted to confirm survival benefits.”

Individuals with the BRCA1 and/or BRCA2 mutations should speak with their healthcare providers regarding their individual risks and benefits of every prevention and screening strategy for their particular case.

Reference: Heemskerk-Gerritsen B, Menke-Pluijmers M, Jager A, et al. Substantial breast cancer risk reduction and potential survival benefit after bilateral mastectomy when compared with surveillance in healthy BRCA1 and BRCA2 mutation carriers: a prospective analysis. Annals of Oncology. doi: 10.1093/annonc/mdt134. First published online: April 10, 2013.