Legal Articles

November 30, 2010

Can Preventive Surgery Decrease Some Types of Cancer?

Cancer researchers report evidence supporting prophylactic surgery of “at risk” tissue to reduce the risk of ovarian and breast cancer in some women.

Bilateral prophylactic mastectomy (removal of health breasts) and prophylactic salpingo-oophorectomy (removal of healthy fallopian tubes and ovaries) appear to be effective for women who carry the BRCA1 and BRCA2 mutations. Such procedures do not guarantee the patient will be cancer free, however.

BRCA1 and BRCA2 are human genes that belong to a class of genes known as tumor suppressors. Mutation of these genes has been linked to hereditary breast and ovarian cancer. Studies indicate that a woman who inherits certain mutations (or changes) in the BRCA1 and BRCA2 genes have a 60-85 percent risk of developing breast cancer and a 16-65 percent risk of developing ovarian cancer by age 70.

One study conducted by the Memorial Sloan-Kettering Cancer Center in New York involved 170 women over 35 years of age who carrier either the BRCA1 or BRCA2 genetic mutation. Patients opted to undergo either preventive surgery or surveillance (which included mammograms, twice-yearly gynecologic exams, twice-yearly vaginal ultrasound exams, and blood tests) for breast and ovarian cancer.

The results: three of 98 women who chose preventive surgery were diagnosed with breast cancer and one with cancer of the lining of the abdomen. By contrast, eight of the 72 women who chose surveillance were diagnosed with breast cancer, four with ovarian cancer and one with cancer of the lining of the abdomen.

Women with a family history of breast or ovarian cancer should be tested for BRCA1 and BRCA2 mutations. Several testing methods are available, usually involving blood samples. Genetic counseling is also recommended.

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