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- W2123661807 abstract "TheidentificationoftheBRCA1andBRCA2genemutationswas amilestoneinthefighttoeradicatebreastcancer.Wehopedwewould soonbeabletopreventnotonlyhereditarybreastandovariancancers (HBOC), but sporadic tumors as well. In this struggle, unfortunately, victories are rarely as sweeping as they first appear. It has been more than 10 years since genetic tests for HBOC became commercially available. A recent analysis of surveillance for women with familial breast cancer in Norway and the United Kingdom revealed that, once diagnosed with apparently early-stage breast cancer, BRCA2 carriers and women who tested negative for BRCA mutations had 5-year survival rates of 96% and 90% respectively, compared with only 70% for women carrying BRCA1 mutations. 1 Howcanweimprovepreventionforwomenathighriskofbreast cancer? Surveillance can be enhanced by use of magnetic resonance imaging of the breasts. 2 Tamoxifen also reduces breast cancer risk in BRCA2 mutation carriers and the risk of contralateral second primaries in both BRCA2 and BRCA1 carriers, 2 but the intervention that most effectively prevents breast cancer is bilateral prophylactic mastectomy(BPM). 2,3 Bilateralprophylacticoophorectomybeforeage40 and contralateral prophylactic mastectomy also reduce breast cancer risk substantially. Womenwhoaremutationcarriersorhavefamilialcancerarefar morelikelytohavebilateralprophylacticoophorectomythanBPM. 2,3 At-risk women in the United States have one of the highest BPM rates (36%), with such surgery much less frequent among European women. 2 Factors predictive of choosing BPM include having a sister who had breast cancer, 4 being a BRCA1/2 mutation carrier, havingapersonalhistoryofbreastcancer,beingyoungeratthetimeof surgery than women who choose surveillance, and having high anxiety and exaggerated perceptions about risk of breast cancer. 5 Women with young children may choose BPM to maximize their chances of long-term survival. 6" @default.
- W2123661807 created "2016-06-24" @default.
- W2123661807 creator A5000677955 @default.
- W2123661807 date "2008-08-20" @default.
- W2123661807 modified "2023-10-16" @default.
- W2123661807 title "A Lesser Evil: Prophylactic Mastectomy for Women at High Risk for Breast Cancer" @default.
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- W2123661807 doi "https://doi.org/10.1200/jco.2008.17.4227" @default.
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