Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Breast-sparing surgery an option for women with breast cancer gene mutation


Hormonal treatments reduce risk of cancer returning, finds 10-year study

Women diagnosed with breast cancer who carry a certain genetic mutation can have breast-sparing surgery but should consider hormonal treatments to reduce their risk of cancer returning.

Those are the findings of a 10-year study led by researchers at the University of Michigan Comprehensive Cancer Center. The study authors found that women with the genetic mutation who had their ovaries removed or took the anti-estrogen drug tamoxifen had lower rates of breast cancer recurrence or new breast cancers in the other breast.

Women who carry a mutation on the BRCA1 or BRCA2 gene are at an increased risk of breast cancer compared to women without the mutation. And once diagnosed with breast cancer, they face a higher rate of a second tumor occurring. Because of this, questions remain about whether these women should undergo breast-conserving surgery instead of mastectomy, which removes the entire breast.

In this study, published in the June 1 issue of the Journal of Clinical Oncology, researchers from 11 sites in the United States, Canada and Israel looked at 160 women with early breast cancer and the BRCA1 or BRCA2 gene mutations. The women were treated with lumpectomy, surgery to remove only the tumor, followed by radiation therapy. These women were compared to 445 similar women who were treated for breast cancer but did not carry the genetic mutations.

After 15 years, both groups of women had similar rates of the tumor reoccurring in the same breast. But among the women with the BRCA1 or BRCA2 mutations, those who were further treated by having their ovaries removed, a procedure called oophorectomy, were less likely to have a recurrence. Similarly, tamoxifen dropped the risk of same-breast recurrence for the mutation carriers by 58 percent.

Women with the genetic mutations had a significantly greater risk of developing breast cancer in the opposite breast than did the control group. After 15 years, 45 percent of the women with the mutation who had not undergone oopherectomy developed a second breast cancer in the other breast, compared to only 9 percent of those women without the genetic mutation.

Women with the mutation who took tamoxifen had a 69 percent reduction in breast cancer in the opposite breast. Among women who did not undergo oophorectomy, tamoxifen made a significant difference: 6 percent of those taking tamoxifen had a second cancer in the opposite breast after 15 years, compared to 54 percent of those who did not take tamoxifen.

“For women with early stage breast cancer who are BRCA1 or BRCA2 carriers, our 10-year data suggest that oophorectomy or tamoxifen in women treated with breast conservation and radiation therapy help to reduce the risk of recurrences and new primary cancers in the treated breast to levels comparable to those observed in women with early stage breast cancer who are not BRCA1 or BRCA2 carriers,” says lead study author Lori J. Pierce, M.D., professor of radiation oncology at the U-M Medical School.

“However, carriers must understand that the risk of breast cancer in the opposite breast still remained significantly greater than in women without a mutation. Thus, it is very important that women who choose breast preservation discuss with their doctors surveillance strategies not only of the involved breast but also in the opposite breast,” she says.

Oophorectomy is a common procedure for women with the BRCA1 or BRCA2 gene mutations because it reduces the risk of ovarian cancer, which is also higher in women with these mutations. Tamoxifen is commonly prescribed to treat breast cancer that is responsive to estrogen.

Many women with the genetic mutations will have both their breasts removed before cancer develops as a preventive strategy. After breast cancer develops, bilateral mastectomy reduces the risk of it recurring by at least 90 percent. But studies have shown approximately the same number of breast cancer patients with the mutations choose mastectomy and breast conservation, suggesting considerable interest in breast conservation among this group of women.

“We need to look to hormonal therapies that may lead to greater risk reductions than tamoxifen. For example, recent studies suggest comparable risk reductions with raloxifene and tamoxifen but fewer side effects with raloxifene. Studies are needed to assess the effect drugs such as raloxifene or aromatase inhibitors have in preventing second tumors in breast cancer mutation carriers,” Pierce says.

This year, 212,920 women will be diagnosed with breast cancer. About 1 in 300 people carry the BRCA1 or BRCA2 gene mutation. For information about breast cancer or genetic counseling, visit or call the Cancer AnswerLine at 800-865-1125.

In addition to Pierce, U-M study authors were Merav Ben-David, M.D., clinical lecturer in radiation oncology; Sofia Merajver, M.D., Ph.D., professor of internal medicine; Albert Levin, Ph.D.; and Sharon Kardia, Ph.D., associate professor of epidemiology. Other authors were Timothy Rebbeck, Lawrence Solin, Eleanor Harris, and Barbara Weber, all from the University of Pennsylvania; Eitan Friedman from the Sheba Medical Center in Israel; David Gaffney from the University of Utah; Bruce Haffty from Yale University; Laura Dawson, Steven Narod and Kelly Metcalfe, all from the University of Toronto; Ivo Olivotto from the British Columbia Cancer Agency; Andrea Eisen and Timothy Whelan from the Hamilton Regional Cancer Center in Ontario; Olufunmilayo Olopade from the University of Chicago; Claudine Isaacs from Georgetown University; and Julia Wong and Judy Garber from Dana Farber Cancer Institute.

Funding for the study was from the Breast Cancer Research Foundation, National Institutes of Health and National Cancer Institute.

Reference: Journal of Clinical Oncology, June 1, 2006, Vol. 24, No. 16, pp. 2437-2443.

Nicole Fawcett | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

Im Focus: Ultra-thin ferroelectric material for next-generation electronics

'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.

Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Resolving the mystery of preeclampsia

21.10.2016 | Health and Medicine

Stanford researchers create new special-purpose computer that may someday save us billions

21.10.2016 | Information Technology

From ancient fossils to future cars

21.10.2016 | Materials Sciences

More VideoLinks >>>