 |
|
Second breast cancer may be greater than thought for high-risk women without BRCA mutations
May 05, 2008Finding also raises questions about the use of sentinel node biopsy with prophylactic mastectomies in high-risk women
New York, NY- A preliminary analysis of ongoing research suggests that high-risk women with breast cancer who do not have a BRCA1/2 mutation may face a greater chance for developing a second breast cancer than previously thought. With the increased risk of cancer in these women, should sentinel node biopsy be considered at the time of prophylactic mastectomy, and how can women best be counseled after these findings?
The increased risk of developing breast cancer is already understood for women with the disease who test positive for a BRCA1 or 2 mutation. Many of these women choose to have their breast(s) surgically removed (prophylactic mastectomy) to reduce their risk of developing breast cancer or developing a second breast cancer The role of sentinel node biopsy remains controversial in this group.
"We know more about counseling women regarding prophylactic mastectomy if they have a BRCA mutation," says Shawna C. Willey, MD, FACS, a member of the Breast Cancer Program at the Lombardi Comprehensive Cancer Center and director of the Betty Lou Ourisman Breast Health Center at Georgetown University Hospital. "In high-risk women who have cancer but don't have a known mutation, we generally advise that the risk of developing a second cancer in the same or opposite breast is lower than it is for women who test positive for a mutation. This latest analysis has us re-thinking our approach."
Willey, the incoming president of the American Society of Breast Surgeons, is the lead author of the study presented today at the society's annual meeting in New York City.
The study included women in a familial cancer registry at Lombardi who were enrolled between 1998 and 2007. The registry participants had a least a 10 percent probability of carrying a BRCA1/2 mutation based on personal or family history of cancer. The cohort for the study included 119 women. 74 women had a BRCA mutation (group 1) and 45 did not test positive for the mutation (group 2). The women in group 2 already had known malignancies and had preoperative genetic testing. All the women opted to have a mastectomy to remove their affected breast (group 2) or surgery to remove both breasts (both groups). They all had both breasts removed, but in Group 2 they all had a unilateral prophylactic mastectomy.
"We examined the rate of occult malignancies in both these groups of women in the prophylactic mastectomy specimens," Willey explains. "What we found was interesting. There was a higher than expected presence of disease in the women who did not test positive for a BRCA mutation.
"The higher rate of occult cancers in group 2 may be because they all had contralateral known malignancies, but this study supports the use of prophylactic mastectomy as an option for these women as it is for those who have a BRCA mutation," says Willey.
Willey notes that additional studies should address the role of sentinel node biopsy for high-risk women who are receiving prophylactic mastectomy.
"We need a better understanding of the incidence of cancer in these women to help determine the need for sentinel lymph node biopsy at the time of mastectomy, even in patients in which mastectomy is entirely prophylactic," says Willey. "There are risks and serious side effects involved with sentinel node biopsy. We will need to find a balance between offering appropriate care and over-treating these women.
"The trend in this study highlights the importance of counseling all high-risk women about their risk of developing another cancer when considering surgical options including sentinel node biopsy."
Georgetown University Medical Center
"We know more about counseling women regarding prophylactic mastectomy if they have a BRCA mutation," says Shawna C. Willey, MD, FACS, a member of the Breast Cancer Program at the Lombardi Comprehensive Cancer Center and director of the Betty Lou Ourisman Breast Health Center at Georgetown University Hospital. "In high-risk women who have cancer but don't have a known mutation, we generally advise that the risk of developing a second cancer in the same or opposite breast is lower than it is for women who test positive for a mutation. This latest analysis has us re-thinking our approach."
Willey, the incoming president of the American Society of Breast Surgeons, is the lead author of the study presented today at the society's annual meeting in New York City.
The study included women in a familial cancer registry at Lombardi who were enrolled between 1998 and 2007. The registry participants had a least a 10 percent probability of carrying a BRCA1/2 mutation based on personal or family history of cancer. The cohort for the study included 119 women. 74 women had a BRCA mutation (group 1) and 45 did not test positive for the mutation (group 2). The women in group 2 already had known malignancies and had preoperative genetic testing. All the women opted to have a mastectomy to remove their affected breast (group 2) or surgery to remove both breasts (both groups). They all had both breasts removed, but in Group 2 they all had a unilateral prophylactic mastectomy.
"We examined the rate of occult malignancies in both these groups of women in the prophylactic mastectomy specimens," Willey explains. "What we found was interesting. There was a higher than expected presence of disease in the women who did not test positive for a BRCA mutation.
"The higher rate of occult cancers in group 2 may be because they all had contralateral known malignancies, but this study supports the use of prophylactic mastectomy as an option for these women as it is for those who have a BRCA mutation," says Willey.
Willey notes that additional studies should address the role of sentinel node biopsy for high-risk women who are receiving prophylactic mastectomy.
"We need a better understanding of the incidence of cancer in these women to help determine the need for sentinel lymph node biopsy at the time of mastectomy, even in patients in which mastectomy is entirely prophylactic," says Willey. "There are risks and serious side effects involved with sentinel node biopsy. We will need to find a balance between offering appropriate care and over-treating these women.
"The trend in this study highlights the importance of counseling all high-risk women about their risk of developing another cancer when considering surgical options including sentinel node biopsy."
Georgetown University Medical Center
Mastectomy Current Events and Mastectomy News RSSPlastic surgeons offer microsurgery technique for breast reconstruction, tummy tuck after mastectomy
Since her teens, Jennifer Jablon had watched family members deal with breast cancer during their 40s, 50s, and 60s. She wondered whether it would be her fate too.
UB Study Explores How Women Make Decisions About Breast Cancer Surgery
For women just diagnosed with breast cancer, one of the important decisions confronting them is whether to have a lumpectomy or mastectomy. A diagnosis of breast cancer will affect one in every eight women in the United States.
Although more older women receive breast-conserving therapy, gaps in treatment exist
According to a new study published in the October issue of the Journal of the American College of Surgeons, although breast-conserving surgery (BCS), commonly known as lumpectomy, is increasingly being used to treat older women with nonmetastatic invasive breast cancer, there are still significant socioeconomic and geographic disparities in the use of this type of therapy.
More women choosing to remove healthy breast after cancer diagnosis
A new study of New York State data finds that the number of women opting for surgery to remove the healthy breast after a cancer diagnosis in one breast is rising, despite a lack of evidence that the surgery can improve survival.
Research needed to learn which DCIS patients may be candidates for less invasive therapy
Ductal carcinoma in situ (DCIS), the most common non-invasive lesion of the breast, presents unique challenges for patients and providers largely because the natural course of the untreated disease is not well understood.
MRI may be unnecessary prior to treatment in most newly diagnosed breast cancer patients
New research findings published in the August issue of the Journal of the American College of Surgeons challenge the routine use of magnetic resonance imaging (MRI) as a means to improve surgical outcomes in newly diagnosed breast cancer patients.
MRI may cause more harm than good in newly diagnosed early breast cancer
A new review says using magnetic resonance imaging (MRI) before surgery to assess the extent of early breast cancer has not been shown to improve surgical planning, reduce follow-up surgery, or reduce the risk of local recurrences.
Women often opt to surgically remove their breasts, ovaries to reduce cancer risk
Many women at high risk for breast or ovarian cancer are choosing to undergo surgery as a precautionary measure to decrease their cancer risk.
Nerve-block anesthesia can improve surgical recovery, even outcomes
When planning for surgery, patients too often don't consider the kind of anesthesia they will receive. In fact, the choice of anesthesia can improve recovery, even outcomes.
RI Hospital first in country to enroll patient in new study for recurrent chest wall breast cancer
Rhode Island Hospital is one of only four sites across the country to participate in a new clinical trial called the DIGNITY Study.
More Mastectomy Current Events and Mastectomy News Articles
|
Lace & Satin Mastectomy Bra, White, 36C by Gelmart | |
 |
Why I Wore Lipstick: To My Mastectomy by Geralyn Lucas (Author) NOW A LIFETIME ORIGINAL MOVIE PREMIERING IN OCTOBER!Having recently graduated from Columbia Journalism School and landed her dream job at 20/20, the last thing 27-year-old Geralyn expects to hear is a breast cancer diagnosis. And there is one part of the diagnosis that no one will discuss with her: what it means to be a young girl with cancer in a beauty-obsessed culture. Trying to find herself, while losing her vibrancy and her looks, Geralyn embarks on a road to self-acceptance that will inspire all women. Although her book is explicitly about a period of time where she was driven by fear and uncertainty about the future, Geralyn managed a transformation that will encourage all women under siege to discover their own courage and beauty. The important and outrageous lessons of Why I... |
 |
Nearly Me Leisure Mastectomy Bra 500 - Small by Active Forever Nearly Me ™ Leisure Mastectomy Bra 500 The Nearly Me Leisure Mastectomy Bra 500 is designed to restore your feminine features and enable you to enjoy your leisurely activities without receiving unwanted stares. The leisure mastectomy bra comfortably stretches and provides breathable support, which is great if you've recently had mastectomy surgery or need mastectomy breast forms due to surgery. This style offers full coverage over the breast, under the arm and across the back comfortably. Cups have soft cotton pockets to help protect tender skin and form. Ideal for leisure wear or sleeping, the Nearly Me Leisure Mastectomy Bra 500 is designed to hold a variety of mastectomy forms without making you feel uncomfortable. If you've recently undergone mastectomy surgery as part of your... |
 |
Camp Mastectomy Bra Style 210 - On Sale!!, 40D, Pink by Camp Sizes: 32-42A, 32-44B, 34-48C, 36-48D, 36-48DD |
 |
Mama Said There'd Be Days Like This: A Twelve Step Guide to Surviving a Mastectomy by Karen Klein (Author) This book, written by a woman who has undergone breast cancer surgery, presents a series of guiding principles and excercises that can help those who are working to overcome the psychological effects of a mastectomy, as well as those who are just interested in understanding the types of issues and emotions involved. |
 |
Still You Post Mastectomy Fiber Filled Pad by Still You The Still YouTM breast replacement is the newest concept in prosthetic design. It is lightweight, realistic, molds to the chest wall and stays in place. It is ideal for swimming and active wear. A matching empty cup is sold with the Illusion to provide smoothness across both breasts. The Illusion is physician approved, and is made to wear with the Still You Tank Tops, and Still You Loungewear. |
|
5398 A38 Black Anita Post Mastectomy Bra by Anita 5398 A38 BLACK ANITA | |
 |
After Mastectomy: Healing Physically and Emotionally by Rosalind Benedet NP (Author), Bob Hogenmiller (Illustrator) This sensitive medical book balances the emotional and biological challenges a woman faces during the post-operation stage of breast cancer by offering wisdom and practical advice. Issues addressed include recovering at home, coping emotionally, and redefining body image. Prosthetics, reconstructive surgery, nutrition, exercise, lymphedema, and follow-up treatment are also discussed. |
 |
Still You Bra. Soft, Simple Sleek Mastectomy Bra. by Still You |
|
Why I Wore Lipstick to My Mastectomy |
| © 2009 BrightSurf.com |