Home Medizin Risikomindernde Mastektomien senken die Brustkrebsinzidenz und -mortalität bei BRCA-Varianten-Trägern

Risikomindernde Mastektomien senken die Brustkrebsinzidenz und -mortalität bei BRCA-Varianten-Trägern

von NFI Redaktion

A study led by Professor Kelly Metcalfe from the Lawrence Bloomberg Faculty of Nursing and researchers at the Familial Breast Cancer Research Unit at Women’s College Hospital concludes that risk-reducing mastectomies (RRM) in women with a genetic BRCA1 or BRCA2 variant significantly reduces the risk of developing breast cancer and decreases the probability of mortality. The study, published in the British Journal of Cancer, examined the impact of RRM on the mortality rate of women with a pathogenic variant but no diagnosis of cancer. This is one of the few studies to quantify the benefits associated with RRM for women.

„The decision for risk-reducing mastectomy is often a difficult one for a woman, and the more evidence we can provide for this decision, the more informed her care plan will be,“ says Metcalfe, also the lead scientist at Women’s College Research Institute.

For women with an inherited BRCA1 or BRCA2 variant, the lifetime risk of developing breast cancer is 80 percent. Studies have shown that RRM reduces the risk of breast cancer by 90 percent, and in Canada, 30 percent of women with a pathogenic variant opt for this operation. According to Metcalfe, this is one of the most effective methods for preventing breast cancer in women with this risk profile.

As part of a pseudo-randomized study, Metcalfe and her team tracked over 1600 participants from nine different countries with a pathogenic BRCA-1/2 variant over a period of six years, with half of the women undergoing risk-reducing mastectomy.

At the end of the trial, the group that opted for RRM had 20 cases of breast cancer and two deaths, while the control group had 100 cases of breast cancer and seven deaths. RRM reduced the risk of breast cancer by 80 percent and the likelihood of dying from breast cancer 15 years after the risk-reducing mastectomy was less than one percent.

„Although this study did not show a significant difference in deaths between the two groups, we know that risk-reducing mastectomy significantly reduces the risk of ever developing breast cancer,“ says Metcalfe.

Metcalfe highlights the need to observe these participants over a longer period to provide more evidence for a more precise assessment of the actual mortality risk and to emphasize the benefits associated with this type of operation.

„Currently, we have good screening for breast cancer, including breast MRI, so surgery is only offered as an option and not a recommendation. However, as further studies are conducted to evaluate the course and risk factors of women after RRM, we will know whether these guidelines need to be changed in the future,“ says Professor Kelly Metcalfe from the Lawrence Bloomberg Faculty of Nursing.

Source:

Journal reference:

Metcalfe, K., et al. (2024). Risk-reducing mastectomy and breast cancer mortality in women with a BRCA1 or BRCA2 pathogenic variant: an international analysis. British Journal of Cancer. doi.org/10.1038/s41416-023-02503-8.

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