New study finds that preventive surgery in women with certain genes may reduce their chances of getting breast cancer

WHEN it comes to the big C (aka cancer), it's clear that it's touching more lives than ever before and not just because of our genetics but often due to the way we live.

Recent studies, like the one in the British Journal of Cancer, bring some hope, especially for women battling the issue of breast cancer risk due to faulty inherited genes known as BRCA1 or BRCA2.

Imagine knowing that you are at high risk of developing breast cancer just because of your family history. It's a heavy weight to carry.

According to the study, women with an inherited BRCA1 or BRCA2 variant face an 80 per cent risk of developing breast cancer over their lifetime.

However, the research revealed that RRM could reduce the risk of breast cancer by 80 per cent, and lower the probability of dying from breast cancer 15 years after the surgery to less than one per cent.

Professor Kelly Metcalfe from the University of Toronto, Canada, stressed the importance of providing women with evidence-based information when considering the decision to undergo risk-reducing mastectomy.

She stated: "The decision to have a risk-reducing mastectomy is often difficult for a woman to make and the more evidence we are able to provide them with when they are making that decision, the more informed their care plan will be."

The study focused on women with an inherited BRCA1 or BRCA2 variant, who have an 80 per cent risk of developing breast cancer over their lifetime.

This research sheds light on the potential benefits of risk-reducing mastectomies for women with this genetic predisposition, offering valuable insights for informed decision-making and personalised care plans.

Studies have shown that an RRM reduces the risk of breast cancer by 90 per cent, and in Canada, 30 per cent of women with a pathogenic variant opt for this surgery.

It is one of the most effective ways of preventing breast cancer in women with this risk profile, Metcalfe said.

What is RRM and how does it reduce the risk of breast cancer?

Risk-reducing mastectomy (RRM) is a surgical procedure in which one or both breasts are removed to reduce the risk of developing breast cancer.

This procedure is often considered by women who have an inherited BRCA1 or BRCA2 variant, which significantly increases their lifetime risk of developing breast cancer.

Are there any other alternatives to risk-reducing mastectomy?

While RRM is an effective risk-reducing option, there are alternative risk-reducing strategies for women with an inherited BRCA1 or BRCA2 variant.

These alternatives may include increased surveillance with regular breast exams, mammograms, and breast MRIs, as well as the use of chemoprevention medications to reduce the risk of developing breast cancer.

What are the long-term effects of risk-reducing mastectomy on women with an inherited BRCA1 or BRCA2 variant?

The long-term effects of risk-reducing mastectomy on women with an inherited BRCA1 or BRCA2 variant can vary. Physically, the procedure may impact body image and self-esteem, and there may be potential complications from the surgery.

Emotionally, the decision to undergo RRM and the subsequent impact on a woman's sense of femininity and identity should also be considered. Additionally, the decision to undergo RRM may have implications for future family planning and relationships.

In this groundbreaking study, researchers tracked over 1,600 participants from nine different countries who carried a pathogenic BRCA1/2 variant for six years. Half of the women opted for risk-reducing mastectomy as part of the study.

After the trial, the researchers observed that the group who underwent risk-reducing mastectomy had 20 incidents of breast cancers and two deaths, while the control group had 100 incidents of breast cancers and seven deaths.

The study revealed that risk-reducing mastectomy reduced the risk of breast cancer by an impressive 80 percent, and the likelihood of dying from breast cancer 15 years after the procedure was less than one per cent.

Metcalfe added: “Although there wasn't a significant difference in deaths between the two groups in this study, we know that a risk-reducing mastectomy significantly reduces the risk of ever developing breast cancer."

She also highlighted the importance of continuing to follow these participants for an extended period to gather more evidence and provide a more precise assessment of the true mortality risk associated with this type of surgery.

Right now, we have good screening in place for breast cancer, including breast MRI, so surgery is only offered as an option, not a recommendation, Metcalfe said.

But with more studies being conducted to assess women's trajectory and risk factors following RRM, we will know whether these guidelines need to be changed in the future, she added.