Featured Research

from universities, journals, and other organizations

Hereditary Breast Cancer: Some Women Choose Mastectomy Over Lifetime Surveillance

Date:
April 16, 2008
Source:
ECCO-the European CanCer Organisation
Summary:
Some women who carry the BRCA gene mutation, which predisposes to breast cancer, may choose to have a prophylactic mastectomy rather than undertake lifetime surveillance. In addition, that the costs of screening for BRCA carriers are very high, and even more so because the MRI that is used can have a high false positive rate, leading to further investigations.

Some women who carry the BRCA gene mutation, which predisposes to breast cancer, may choose to have a prophylactic mastectomy rather than undertake lifetime surveillance, a Dutch scientist will tell the 6th European Breast Cancer Conference (EBCC-6) on April 16. The mastectomy option appears to give an excellent result in avoiding breast cancer, with a remaining risk of less than 1%, Dr. Reinie Kaas, from the Surgical Department of the Netherlands Cancer Institute, Amsterdam, The Netherlands, wil say.

Dr. Kaas set out to study the effects of prophylactic mastectomy in 250 patients who were BRCA carriers. "It was thought that after such a mastectomy the risk of being diagnosed with breast cancer was about 5%," she says "and therefore there was debate about whether continued surveillance was necessary or not. We decided to try to answer this question in order that women at high risk should be able to make an informed choice."

Women with mutations in the BRCA1 or BRCA2 genes have an estimated lifetime risk of developing breast cancer of about 85%. Currently strategies to deal with this risk are surveillance with monthly breast self-examination, bi-annual clinical breast examination by a physician and annual mammography plus breast MRI, or prophylactic mastectomy, where the entire breast is removed. About half of the carriers choose the latter strategy. The surveillance strategy does not prevent breast cancer, and especially in BRCA1 carriers, who mostly have fast growing tumours, 25-30% of carriers are diagnosed when the tumour is already more than 2cm in diameter.

Dr. Kaas and her team found that only one out of the 250 carriers studied was diagnosed with a breast cancer, and this was likely to be because the axillary tail (a small part of the breast that extends towards the armpit) had not been completely removed. "Our epidemiologists are investigating how many breast cancers are avoided up to the age of 80 in these women," she says. "But on current evidence we can safely state that continued follow-up, which can be costly as well as stressful for the patient, is not warranted in patients who have had a prophylactic mastectomy. Surveillance in those BRCA carriers who do not opt for mastectomy has to start at an early age, and the frequent visits to the doctor and the many examinations which need to be undertaken regularly can be a source of great stress for many women.

"However, the decision to remove healthy breasts is solely the decision of the woman, and healthcare services should not press women to make this choice simply to reduce costs."

In another presentation to the conference April 16 Dr. Yvonne Kamm, a medical oncologist from the Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands, will say that the costs of screening for BRCA carriers are very high, and even more so because the MRI that is used can have a high false positive rate, leading to further investigations.

"The MRI is expensive in itself, but useful because it can detect very small tumours which might not be picked up otherwise. But it also detects many other abnormalities that are not cancer, and this implies not just extra cost but also considerably anxiety for the women concerned," she says.

Between September 1999 and 2005, Dr. Kamm and her team screened 196 women at risk of hereditary breast cancer. When an abnormality was found, the women underwent further investigations. The women were screened for a median period of 2 years; this included 1149 breast examinations, 494 mammograms, and 436 MRI scans. Abnormalities led to further investigations; 32 breast examinations, 17 mammograms, 64 MRI scans, 114 ultrasound examinations, and 48 biopsies.

The cost of the first screening programme was €254 per woman year, and the extra costs of further investigations €61 per woman year. During the 6 year period 13 cancers were found.

"The total costs to find one breast cancer were high -- €13168," says Dr. Kamm. We know that such intensive screening works, and that it can find breast cancer at an early stage. Therefore, we have made the choice to screen intensively women at very high risk from breast cancer."


Story Source:

The above story is based on materials provided by ECCO-the European CanCer Organisation. Note: Materials may be edited for content and length.


Cite This Page:

ECCO-the European CanCer Organisation. "Hereditary Breast Cancer: Some Women Choose Mastectomy Over Lifetime Surveillance." ScienceDaily. ScienceDaily, 16 April 2008. <www.sciencedaily.com/releases/2008/04/080415185021.htm>.
ECCO-the European CanCer Organisation. (2008, April 16). Hereditary Breast Cancer: Some Women Choose Mastectomy Over Lifetime Surveillance. ScienceDaily. Retrieved September 3, 2014 from www.sciencedaily.com/releases/2008/04/080415185021.htm
ECCO-the European CanCer Organisation. "Hereditary Breast Cancer: Some Women Choose Mastectomy Over Lifetime Surveillance." ScienceDaily. www.sciencedaily.com/releases/2008/04/080415185021.htm (accessed September 3, 2014).

Share This



More Health & Medicine News

Wednesday, September 3, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Snack Attack: Study Says Action Movies Make You Snack More

Snack Attack: Study Says Action Movies Make You Snack More

Newsy (Sep. 2, 2014) You're more likely to gain weight while watching action flicks than you are watching other types of programming, says a new study published in JAMA. Video provided by Newsy
Powered by NewsLook.com
U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

Newsy (Sep. 2, 2014) The U.N. says the problem is two-fold — quarantine zones and travel restrictions are limiting the movement of both people and food. Video provided by Newsy
Powered by NewsLook.com
Doctors Fear They're Losing Battle Against Ebola

Doctors Fear They're Losing Battle Against Ebola

AP (Sep. 2, 2014) As a third American missionary is confirmed to have contracted Ebola in Liberia, doctors on the ground in West Africa fear they're losing the battle against the outbreak. (Sept. 2) Video provided by AP
Powered by NewsLook.com
Tech Giants Bet on 3D Headsets for Gaming, Healthcare

Tech Giants Bet on 3D Headsets for Gaming, Healthcare

AFP (Sep. 2, 2014) When Facebook acquired the virtual reality hardware developer Oculus VR in March for $2 billion, CEO Mark Zuckerberg hailed the firm's technology as "a new communication platform." Duration: 02:24 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins