Women who have tumors in one breast usually decide to remove both the affected breast and the healthy one for fear that the cancer would return in the latter. But not anymore! Thanks to Houston researchers, women who want to save the healthy breast now have more information which can help them decide what kind of surgery they need.
Dr. Kelly Hunt, an M.D. Anderson professor of surgical oncology and the study’s lead author said the results of their research is meant “to help women make more informed decisions, based on their individual case rather than the general population, about whether to have this aggressive and irreversible procedure. Women often consider it not because of their doctor’s recommendation, but out of fear their cancer will return.”
The study involved 542 women with breast cancer in one breast who underwent surgery to remove both breasts between 2000 and 2007. The study found that 25 of the participants had breast cancer in the other breast that tests had missed, 82 women had abnormal cells that signify higher risk, and 435 had no to very low risk.
Based on these findings, the researchers identified three factors associated with cancer in the healthy breast. First, having more than one tumor in the same breast when the initial cancer is diagnosed made the cancer in the other breast more likely to come back. Secondly, the risk was increased when having invasive lobular breast cancer, which begins in the milk-producing glands and invades surrounding tissue. Last but not least, results of the Gail model test can inform a patient whether her risk of breast cancer recurrence is higher.
The Gail model test determines a woman’s chance of developing breast cancer by evaluating five personal and family predictors of breast cancer including age, age at first period, number of breast biopsies performed, age at the birth of first child, and number of immediate relative who have had breast cancer.
Neither race nor the hormone receptor status of the cancer helped determine risk of developing cancer in the future in a woman’s healthy breast, the study found.
The researchers also did not take into account whether mutations in the genes BRCA1 and BRCA2 known to increase the risk of breast cancer also increased risk of cancer in the healthy breast. Previous studies have shown that many women with these mutations choose preventive mastectomies even before any tumor has appeared in either breast.
Last year, a study revealed that the number of breast cancer patients choosing to have a double mastectomy more than doubled from 1998 to 2003. The study of Houston researchers wants to prevent so many women from having their both breasts removed, a decision that may affect their lives more than they can even imagine.
Breast cancer kills annually around 465,000 women, while about 1.3 million other women are diagnosed with the disease, according to the American Cancer Society.
The study will be published in the March 1, 2009 issue of Cancer, the journal of the American Cancer Society.
