Preventive Breast Cancer SurgeryLast updated: May 15, 2013
With recent press about actor Angelina Jolie’s preventive (prophylactic) double mastectomy, some women and men who have known or potential risk for breast cancer might wonder if they, too, should have surgery to prevent the disease.
“If you are concerned about your risk for breast cancer,” says Summit Medical Group breast surgeon John D. Cunningham, MD, “you should first have genetic testing to determine whether you carry a mutation for the BRCA1 or BRCA2 gene. If you test positive for the mutation, you should then discuss all options with your breast surgeon.” Dr. Cunningham notes, “Although preventive mastectomy can be an effective option for some women and men with high risk for breast cancer, it is not the only approach for helping prevent or delay onset of breast cancer.”
Other options for preventing or delaying the development of breast cancer include:
- Frequent clinical breast exams and mammogram and/or ultrasound screening
- Chemoprevention, including tamoxifen, other medicines, and vitamins
- Partial mastectomy
Although preventive mastectomy can help reduce the risk of cancer, it is important to remember that it does not ensure that a woman or man will never get breast cancer.
Breast Cancer Facts
The National Cancer Institute (NCI) estimates that 12 percent (120 in 1000) of US women will develop breast cancer. Women who have a mutation for the BRCA1 or BRCA2 genes, however, have 5 times the risk of developing breast cancer (60 percent or 600 in 1000) compared with women who do not have the mutation. Men who carry the gene mutation also have greater risk of mammary cancer compared with men who do not carry it.1
Research shows that BRCA genetic mutations are more common in women and men of eastern European Jewish, Dutch, Norwegian, and Icelandic descent compared with people of other ethnic backgrounds. In addition to having greater risk for breast cancer, women with the mutation have an increased risk of ovarian cancer, and men with the mutation have a greater risk of prostate cancer. Both men and women with the mutation have a higher risk of pancreatic cancer compared with people who do not have the mutation.1
Breast Cancer Risk
Although certain risk factors can increase your odds of getting breast cancer, they do not guarantee you will get the disease. For example, some women with 1 or more breast cancer risk factors never develop breast cancer. It is still important to be aware of your risk, regularly examine yourself for changes in your breasts, and see your doctor for routine breast checkups.
Your breast cancer risk is greater if you:1
- Have a history of cancer in 1 breast, which makes you 3 to 4 times more likely to develop breast cancer unrelated to your first breast cancer
- Have a mother, sister, or daughter (a first-degree relative) who has or has had breast cancer, especially if it occurred before menopause and if it was in both breasts, which doubles your odds of getting the disease
- Have 2 first-degree relatives who have had or have breast cancer, which makes you 5 times more likely to get breast cancer
- Have a male relative who has had or has breast cancer, which increases your risk of getting the disease
- Are age 50 years or older - studies show 77% of women with breast cancer are age 50 years or older
- Are age 65 or older - studies show 50% of women with breast cancer are age 65 years or older
- Have inherited alterations in the BRCA1 or BRCA2 breast cancer genes, which increase your risk of getting breast cancer as much as 85%
- Have had certain breast lesions known as atypical lobular or ductal hyperplasia or lobular carcinoma, which makes it 4 to 5 times more likely you'll get breast cancer
- Are obese
- Have certain ethnic background
Early breast cancer detection
and breast cancer treatment can save your life!
In addition to identifying people who carry the BRCA1 or BRCA2 mutations, genetic testing can offer peace of mind to those who receive a negative result. If you receive a positive test result, you are then better positioned to make decisions that can help protect your health.
"The bottom line," says Dr. Cunningham, "is that some people are in a special risk category for breast cancer. Although preventive double mastectomy can dramatically reduce risk of breast cancer, the decision to opt for it should be thoughtfully discussed with a breast surgeon."
For more information or to schedule an appointment,
call Summit Medical Group Breast Care Center today
1) National Cancer Institute. Surveillance, Epidemiology, and End Results (SEER). SEER stat fact sheet: breast. http://seer.cancer.gov/statfacts/html/breast.html. Accessed May 15, 2013.