Preventive Cancer Surgeries May Save Lives

A new study underscores the importance for women with a family history of breast or ovarian cancer to get genetic counseling and testing for the BRCA1 and BRCA2 genes that make them more likely to develop lethal breast or ovarian cancer, says a Northwestern Medicine oncologist.    The study, which was published in the Sept. 1 issue of the Journal of the American Medical Association (JAMA), shows women with the gene live longer and nearly eliminate their risk of cancer by having prophylactic surgeries to remove their ovaries and fallopian tubes (salpingo-oophorectomy) or their breasts in a mastectomy.

“This is the first study to prove women survive longer with these preventive surgeries and shows the importance of genetic testing when there is a family history of early breast or ovarian cancer,” said Virginia Kaklamani, M.D., co-author of an accompanying editorial in JAMA. Kaklamani is director of translational breast cancer research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. She also is an associate professor of medicine at Northwestern University Feinberg School of Medicine and an oncologist at Northwestern Memorial Hospital.

In the editorial, Kaklamani and coauthor, Laura Esserman, M.D., a physician at the University of California, San Francisco, describe what the findings mean to women and their physicians.

“Primary care physicians, gynecologists and women need to be more aware that these tests exist,” Kaklamani said. “So if a woman has a family history of ovarian cancer or breast cancer, the woman can be genetically tested. Testing should not start with the oncologists. That’s when patients already have breast cancer. The primary care doctors and gynecologists are the ones who should evaluate patients and offer them genetic counseling.”

About 10 to 20 percent of breast and ovarian cancers are due to BRCA1 or BRCA2 genes. “Most of these women will die of ovarian cancer, so you can save 20 percent of them with the prophylactic surgery,” Kaklamani said. “And you can save the majority of women who would have died of their breast cancer.”

Even women diagnosed with breast or ovarian cancer can still benefit from genetic testing “because the presence of a mutation significantly increases the risk of a second primary (breast or ovarian) diagnosis and often influences the choice of treatments,” the authors write.

While some women diagnosed with the gene mutation may opt for surveillance with an alternating mammogram and breast magnetic resonance imaging every six months, the authors emphasize surveillance is not prevention. And, ovarian cancer screening has limited value.

Women should be aware that options for these preventive surgeries have improved, the authors note. A laparoscopic salpingo-oophorectomy is a relatively low-risk procedure and can be done in an out-patient setting. And cosmetic options for women getting mastectomies have greatly improved.

10 Comments

  1. Julia
    Posted September 8, 2010 at 5:39 pm | Permalink

    This is certainly good news that there are very effective treatments for women who are at a high risk for these kinds of cancer, but it would still be an extremely tough decision to make! Still, it’s good to hear that there are viable options available.

  2. Cahap
    Posted September 10, 2010 at 12:17 pm | Permalink

    This is certainly good news that there are very effective treatments for women who are at a high risk for these kinds of cancer, but it would still be an extremely tough decision to make! Still, it’s good to hear that there are viable options available.

  3. GSD lover
    Posted September 12, 2010 at 9:18 am | Permalink

    Good news! I don`t have a history of cancer in my family, but you never know…

  4. Ethan Madison
    Posted September 12, 2010 at 4:24 pm | Permalink

    can this be prevented if one can have a cervical cancer immunization?

  5. Cancer Terminology
    Posted September 17, 2010 at 7:48 am | Permalink

    The more preventive or early detection options available the better!

  6. Anne Ahira
    Posted September 17, 2010 at 1:17 pm | Permalink

    I don’t have a history of cancer in my family, will there be a possibility to get one?

  7. Cheryl Gowin
    Posted November 12, 2010 at 4:31 pm | Permalink

    The article notes that only about 10 to 20 percent of breast and ovarian cancers are due to BRCA1 or BRCA2 genes. It seems that women need to be aware that this is only one stressor for cancer and not forget about continuing checkups.

  8. Joan Peterson
    Posted March 23, 2011 at 9:10 am | Permalink

    Important that women understand that these preventative measures could be life saving for them. And when one comes to pap smears – my personal experience is that they need to be performed EVERY YEAR – not every 3 as is now recommended by some. If I went by that protocol, I would be dead.

  9. Teresa
    Posted August 16, 2011 at 10:24 am | Permalink

    The more preventive or early detection options available the better!

  10. Dan Roth
    Posted September 26, 2011 at 11:27 am | Permalink

    Are there any peer reviewed studies to support the statement:

    Preventive Cancer Surgeries May Save Lives
    POST A COMMENT (9)
    A new study underscores the importance for women with a family history of breast or ovarian cancer to get genetic counseling and testing for the BRCA1 and BRCA2 genes that make them more likely to develop lethal breast or ovarian cancer, says a Northwestern Medicine oncologist. The study, which was published in the Sept. 1 issue of the Journal of the American Medical Association (JAMA), shows women with the gene live longer and nearly eliminate their risk of cancer by having prophylactic surgeries to remove their ovaries and fallopian tubes (salpingo-oophorectomy) or their breasts in a mastectomy.

    “This is the first study to prove women survive longer with these preventive surgeries and shows the importance of genetic testing when there is a family history of early breast or ovarian cancer,” said Virginia Kaklamani, M.D., co-author of an accompanying editorial in JAMA. Kaklamani is director of translational breast cancer research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. She also is an associate professor of medicine at Northwestern University Feinberg School of Medicine and an oncologist at Northwestern Memorial Hospital.

    In the editorial, Kaklamani and coauthor, Laura Esserman, M.D., a physician at the University of California, San Francisco, describe what the findings mean to women and their physicians.

    “Primary care physicians, gynecologists and women need to be more aware that these tests exist,” Kaklamani said. “So if a woman has a family history of ovarian cancer or breast cancer, the woman can be genetically tested. Testing should not start with the oncologists. That’s when patients already have breast cancer. The primary care doctors and gynecologists are the ones who should evaluate patients and offer them genetic counseling.”

    About 10 to 20 percent of breast and ovarian cancers are due to BRCA1 or BRCA2 genes. “Most of these women will die of ovarian cancer, so you can save 20 percent of them with the prophylactic surgery,” Kaklamani said. “And you can save the majority of women who would have died of their breast cancer.”

    Even women diagnosed with breast or ovarian cancer can still benefit from genetic testing “because the presence of a mutation significantly increases the risk of a second primary (breast or ovarian) diagnosis and often influences the choice of treatments,”

Post a Comment

Your email is never shared. View our commenting policy. Required fields are marked *

*
*