A study by researchers in the U.K. has suggested that young breast-cancer survivors with BRCA gene-mutations are unlikely to benefit from radical breast removal.
BRCA 1 and BRCA 2 are known as tumor suppressor genes which aid DNA repair in breast tissue. When these genes undergo undesirable changes, the risk of breast and ovarian cancer increases. This risk is usually inherited and women with familial history of breast and ovarian cancers are evaluated for mutations in these two genes. Given the increased risk of cancer in breast tissue, those diagnosed with breast cancer are recommended removal of both breasts early during treatment to prevent recurrence.
In 2013, Angelina Jolie triggered immense interest in BRCA gene mutations testing when the star revealed in a New York Times editorial that she had got her breasts removed. She was not diagnosed with cancer.
Jolie’s revelation reportedly led to increase in queries pertaining to BRCA genes and subsequently, increase in number of BRCA gene tests, CNN reports. Women who learn of higher genetic predisposition are often suggested a wait-and-watch approach to catch the cancer early if it occurs.
For their study published in The Lancet Oncology, researchers determined survival rates of 2,733 women who were treated for breast cancer between 2000 and 2008. They found women with BRCA gene mutations had similar survival rates as those without the mutations, in the decade after diagnosis.
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“Patients with young-onset breast cancer who carry a BRCA mutation have similar survival as non-carriers. However, BRCA mutation carriers with triple-negative breast cancer might have a survival advantage during the first few years after diagnosis compared with non-carriers.”
One of the main implications of the research’s findings is choice of a double mastectomy. The surgery is offered as an option to reduce primary cancer risk in the unaffected breast. Women with BRCA gene mutations deferring the surgery will not harm survival, the study says.
According to a CNN report, double mastectomy rates tripled between 2002 and 2012, possibly due to increased availability of BRCA gene screening tests, with interest in the surgery fuelled further by Jolie. CNN also reported BRCA gene testing increased to around 500 per week in the U.S. after the actor’s announcement, from 350 tests before the disclosure.
The Lancet study, like many others, also raised questions about claims of improved survival rates in the case of immediate double mastectomies.
“Although risk-reducing bilateral salpingo-oophorectomy is highly effective at reducing ovarian cancer incidence, the risk of primary peritoneal cancer is not reduced and studies indicate that the previously reported effect of this procedure on future breast cancer risk in BRCA1 and BRCA2 mutation carriers might have been overestimated because of uncorrected bias,” researchers wrote.
The study is restricted to women diagnosed with cancer, as pointed out by support groups working to raise awareness about gene testing. Jolie had claimed her risk of breast cancer reduced from 87 percent to five percent following surgery.