Cancer: preventative surgery could save women with certain gene mutations

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Cancer: preventative surgery could save women with certain gene mutations

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With some 40 000 women dying of breast cancer each year, a new study gives some hope. The risk of breast and ovarian cancer can be significantly reduced by preventative surgery if you have altered BRCA1 or BRCA2 genes. The study was released on 24 February and published in the Journal of Clinical Oncology.

By the age of 70 years around 55% to 65% of women with the BRCA1 gene mutation and 45% with the BRCA2 mutation will develop breast cancer.

This preventative surgery that is known as an oophorectomy, decreases the risk of getting peritoneal, fallopian tube and ovarian cancer by 80% in women with these gene mutations.

Where do BRCA1 and BRCA2 come from?

According to associate professor of Oncology and associate professor of Gynaecology and Obstetrics at The Johns Hopkins Sidney Kimmel Comprehensive Cancer Centre, Deborah Armstrong, “This is a mutation that people inherit from one of their parents – it can come equally from the mother or the father.” Armstrong states that BRCA1 and BRCA2 gene mutations are most commonly linked to ovarian and breast cancer.

When to have the preventative surgery?

According to Armstrong, “When a woman inherits this mutation her lifetime risk of breast cancer and ovarian cancer greatly increases compared to the general population.” She continues, “The biggest problem we have with ovarian cancer is that we don’t have screening like a Pap smear or a mammogram that will pick it up when it is curable.”Thus the study advises women to surgically remove their Fallopian tubes and ovaries before at least the age of 35 years – that is if you have no intention to have more children. Women with the BRCA2 mutation gene could wait to age 40 to have preventative surgery.

How does this gene mutation work?

Properly functioning genes should give the body suppressive proteins that could then in turn repair damaged DNA. But, when these genes malfunction the cells can become cancerous or rogue, increasing rapidly.

Racial differences in frequency and mortality

Although the frequency of Caucasian women getting breast cancer is higher, the African American women with breast cancer are more likely to die, as this disease is generally picked up and treated too late. The Centre for Disease Control and Prevention states that some 1 800 black women die each year from this disease than white women with the same.

The women in the study 

There were a total of 5 783 women who partook in this study from the United States, Europe and Canada. Some 2 274 did not have the preventative surgery, while 2 123 already had the surgery at the inception of the study. About 1 390 women did eventually undergo the surgery in following years.

Alternatives to surgery

Women with these mutation genes, who are refusing to undergo the preventative surgery, can opt for regular pelvic examinations (trans-vaginal ultrasounds). However, Armstrong warns that “none of them are very good at picking up the early stages of the disease.”

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