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Breast Removal Reduces Cancer Risk In Some Women
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Breast Removal Reduces Cancer Risk In Some Women

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Breast Removal Reduces Cancer Risk In Some Women
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MELISSA BLOCK, host:

From NPR News, it's ALL THINGS CONSIDERED. I'm Melissa Block.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

There is news today that could influence a hard decision facing women at high risk of breast and ovarian cancer. A new study shows that women who discover they have a genetic mutation called BRCA can dramatically reduce their odds of developing breast cancer if they choose to have a double mastectomy. Also if they have their ovaries removed, they can further reduce the risk of breast cancer and ovarian cancer.

NPR's Patti Neighmond tells us more about the study's finding.

PATTI NEIGHMOND: Researchers from around the country tracked nearly 2,500 women with BRCA mutations who had surgery to try to prevent breast and ovarian cancer.

Researcher Timothy Rebbeck is an epidemiologist at the University of Pennsylvania.

Dr. TIMOTHY REBBECK (Epidemiologist, University of Pennsylvania): We found that mastectomy provided a huge risk reduction in terms of subsequent breast cancer risk and death. And the risk reduction is probably in the range of 80 to 95 percent.

NEIGHMOND: And for women who had ovaries removed, their risk of ovarian cancer decreased as much as 80 percent. Rebbeck says these are all huge decreases but cautions that cancer risk will never be brought down to zero.

Dr. REBBECK: Because the tissue is never completely removed. Breast tissue is found throughout the torso and can't be completely removed by surgical means. And for ovarian cancer, the ovary leaves behind cells in the perineum that could go on to become cancerous. So it's just not possible to remove all of the tissue that might be at risk.

NEIGHMOND: Nonetheless, Rebbeck says the study findings are extremely reassuring: No breast cancer diagnoses among women who had double mastectomies. Among the women who did not have surgery, seven percent were later diagnosed with breast cancer.

One of the women who had a double mastectomy is 61-year-old Toby, who lives in New Jersey. She doesn't want her last name used because she's worried about her health coverage. But she feels she did the right thing when she had first her ovaries and then both her breasts removed.

Toby's mother died of ovarian cancer. About five years ago, Toby wanted to see if she carried the BRCA mutation. She did. And her doctors initially told her to just watch it very closely.

TOBY: After my genetic testing, they would alternate a mammogram with an MRI every six months. And I thought I was getting very, very good surveillance, and I felt that that would probably be enough. And it would be, you know, I would be in a situation where they would be able to diagnose something very, very early and be able to cure me if I did develop breast cancer.

NEIGHMOND: But another doctor thought otherwise. Breast cancer caused by BRCA mutations are particularly aggressive. Toby's lifetime risk of that type of cancer was as high as 90 percent. Toby had a double mastectomy and was one of the women tracked by researchers in the study - so far so good.

In an editorial accompanying the study, which appears in The Journal of the American Medical Association, oncologist Virginia Kaklamani says the findings are important because lives can be saved if women have genetic testing.

Dr. VIRGINIA KAKLAMANI (Oncologist, Northwestern University): A lot of times, I see these women having had a very preventable breast cancer. Preventable because I can identify the fact that they had a higher risk of getting breast cancer. Had they been genetically tested a few years prior to me seeing them, they would have had the option of having a bilateral mastectomy. So we could have prevented these breast cancers and we didn't.

NEIGHMOND: For Toby, it's been about a year since her surgery. She's had reconstruction. And today, she says she feels physically strong again. But really it's the emotional change that comforts her.

TOBY: My mother left me when I was 26, and it was extremely painful and traumatic for my entire life. And I just didn't want to do that to my children. I had a chance to control that. I had a chance to fight what my mother never had a chance for.

NEIGHMOND: Oncologist Kaklamani says women with the BRCA mutation should be counseled about genetic testing and strongly consider it. After that, the decisions are their own, but the findings of this study, she says, should be extremely useful helping them decide what to do.

Patti Neighmond, NPR News.

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