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Back to Oncology Articles
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Investigators found no increase in the risk of cancer recurrence in young
women with mutations that were treated with conservative surgery.
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Women with hereditary breast cancer treated with breast conserving
therapy appear to have no increased risk for recurrence in the treated
breast, according to results from a prospective study published in the
January 1, 2005 issue of CANCER, a peer-reviewed journal of the American
Cancer Society. However, the risk of breast cancer in the opposite
breast is significantly increased.
Breast conserving therapy (BCT), consisting of lumpectomy and
radiation, has been demonstrated to be a safe, effective treatment for
non-hereditary or sporadic forms of early breast cancer. However, for
hereditary breast cancers – i.e., mutations in BRCA1 and BRCA2 genes –
the use of BCT is controversial due to conflicting data about increased
risk of recurrence in the treated breast and development of new tumors
in the untreated breast. This leaves women with BRCA mutations at a
disadvantage when choosing between BCT and bilateral mastectomy.
Mark Robson, M.D. and his colleagues from Memorial Sloan-Kettering
Cancer Center in New York City followed 87 women diagnosed with breast
cancer and BRCA mutations who were treated with BCT to evaluate their
long-term cancer risks.
The investigators found no increase in the risk of cancer recurrence
in the treated breast, compared to young women without mutations. Ten
years after their initial diagnosis, 13.6 percent of the women with a
genetic mutation had experienced a recurrence similar to previously
published recurrence rates for women with non-hereditary breast cancers
treated with BCT. However, the researchers note that more than half the
women suffered a cancer-related event (recurrence or second primary
cancer) within ten years of their initial diagnosis, including 37.6
percent who experienced a new cancer in the untreated breast. No
clinical risk factors were linked to an increased risk of cancer.
"Breast conserving treatment," conclude the authors, "is a reasonable
option for [women with BRCA mutations], and the indications for
unilateral mastectomy should be the same for both hereditary and
non-hereditary breast cancer." They caution, however, "discussion of
bilateral mastectomy is warranted by the significant contralateral
breast cancer risk."
Source
Article: "Appropriateness of Breast-Conserving Treatment of Breast
Carcinoma in Women with Germline Mutations in BRCA1 or BRCA2: A
Clinic-Based Series," Mark Robson, Tiffany Svahn, Beryl McCormick,
Patrick Borgen, Clifford A Hudis, Larry Norton, Kenneth Offit, CANCER;
Published Online: November 22, 2004 (DOI: 10.1002/cncr.20728); Print
Issue Date: January 1, 2005.
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