Some women’s breast cancer mortality may be lowered by risk-reducing mastectomy: study

Women with a BRCA1 or BRCA2 genetic variation may find that their chance of dying from breast cancer is dramatically decreased by having risk-reducing mastectomies (RRM).

The research looked at how RRM affected the mortality rate of women who had a pathogenic mutation but were not diagnosed with cancer. It was published in the British Journal of Cancer.

Over their lives, women with an inherited BRCA1 or BRCA2 variation are 80% more likely to get breast cancer.

An RRM lowers the risk of breast cancer by 90%, according to research.

“A woman may find it difficult to decide whether to have a risk-reducing mastectomy, but the more information we can give them at that time, the more informed their care plan will be,” stated Prof. Kelly Metcalfe of the University of Toronto’s Lawrence Bloomberg Faculty of Nursing.

According to Metcalfe, thirty percent of Canadian women who have a pathogenic mutation choose to have this operation done. For women with this risk profile, Metcalfe said it’s one of the best strategies to avoid breast cancer.

Metcalfe and her colleagues observed more than 1,600 individuals from a registry of women with a pathogenic BRCA 1/2 variation from nine different countries for six years using a pseudo-randomized study; half of the women had a risk-reducing mastectomy.

At the conclusion of the study, there were 100 incident breast cancer cases and seven deaths in the control group, and 20 incident breast cancer cases and two deaths in the group that chose an RRM.

RRM decreased the risk of breast cancer by 80%, and fewer than 1% of women died from breast cancer 15 years following a risk-reducing mastectomy.

“We know that a risk-reducing mastectomy significantly reduces the risk of ever developing breast cancer,” Metcalfe said, “even though there wasn’t a significant difference in deaths between the two groups in this study.”

Metcalfe noted that keeping track of these patients for a longer amount of time would provide more data to accurately determine the real mortality risk and emphasize the advantages of this kind of surgery.

“Surgery is only offered as an option, not a recommendation, because right now we have good screening in place for breast cancer, including breast MRI,” Metcalfe said.

“However, additional research evaluating women’s trajectory and risk factors after RRM will allow us to determine whether these recommendations need to be adjusted down the road.”