Can Risk-Reducing Mastectomies Lower The Risk Of Breast Cancer Death?

Risk-reducing mastectomies includes either surgically removing both breasts to prevent breast cancer, or removing the disease free breast in women who have had breast cancer in one breast to reduce the risk.

Breast cancer is one of the many aggressive forms of cancer and a leading cause of death. But, it is preventable. Breast cancer happens when breast cells divide and multiply uncontrollably due to mutation in certain genes. Generally, it forms in the milk-producing glands (lobules) of the breast or in the ducts that transport milk from glands to the nipple. Fatty or the fibrous connective tissues of the breast can also be hotspots for growth of cancer cells. In some cases, they may even travel to the lymph nodes under your arms and spread to other body parts. A recent study, however, shed light on its prevention, stating that risk-reducing mastectomies (RRM) may reduce the risk of being diagnosed with breast cancer and also lower the probability of death in women.

What is RRM?

Published in the British Journal of Cancer, the research examined how RRM -- that includes either surgically removing both breasts to prevent breast cancer, or removing the disease free breast in women who have had breast cancer in one breast to reduce the risk in the other breast -- impacts the death rate in women who do not have a cancer diagnosis, but have a pathogenic variant. During a mastectomy, tissues near the breast -- like the lymph nodes -- are also removed.

What is a pathogenic variant?

According to the National Cancer Institute, it refers to a change in the DNA sequence of a gene that causes a person to "have or be at risk of developing a certain genetic disorder or disease, such as cancer". Pathogenic variants can be either inherited from a parent or occur during a person's lifetime.

Professor Kelly Metcalfe from the University in Toronto, Canada, was quoted as saying that the decision to have a RRM is "often difficult for a woman to make". "And the more evidence we are able to provide them with when they are making that decision, the more informed their care plan will be."

Who is at risk?

Researchers say that women who have an inherited BRCA1 or BRCA2 variant have an '80 per cent risk of developing breast cancer' over the course of their lifetime. BRCA1 is an abbreviation for 'BReast CAncer gene 1'. BRCA2 stands for 'BReast CAncer gene 2'. They are genes that produce proteins that help repair damaged DNA.

According to the Centers for Disease Control and Prevention (CDC), women with BRCA1 and BRCA2 mutations are more likely to get breast and ovarian cancer. The most effective prevention option is surgery to remove the breasts.

During the course of the research, it was found that RRM reduces the risk of breast cancer by 90 per cent. In Canada, 30 per cent of women with a pathogenic variant choose to undergo this surgery.

How the study was conducted

According to reports, researchers followed over 1,600 women with a pathogenic BRCA 1/2 variant from nine countries over the course of six years. Half of them had a risk-reducing mastectomy. At the end of the research, it was found that there were '20 incident breast cancers and two deaths' in the group that opted for RRM, and '100 incident breast cancers and seven deaths in the other group.

The final word

RRM reduced the risk of breast cancer by 80 per cent, said researchers, with the probability of dying of breast cancer 15 years after the surgery being less than one per cent.