|Deborah Schrag, Karen M. Kuntz, Judy E. Garber, et al.|
|Abramson Cancer Center of the University of Pennsylvania|
| Last Modified: November 1, 2001
Reviewers: Li Liu, MD
Précis: Theoretical benefit of various cancer prevention strategies for breast cancer patients with BRCA mutations
IntroductionWomen who carry BRCA1 and BRCA2 mutations have a greatly increased risk of breast and ovarian cancers when compared with the general population. The optimal clinical management of women who have had breast cancer with BRCA mutations has not been established. Dr. Deborah Schrag and her colleagues from Memorial Sloan-Kettering Cancer Center report here in the theoretical benefit of various strategies in breast cancer patients with known BRCA1 or BRCA2 mutations.
MethodA hypothetical cohort of breast cancer patients with BRCA1 or BRCA2 mutations were included. They used a decision analysis model to examine the effects of seven prevention strategies on life expectancy and the risk of second cancers: 5 years of tamoxifen therapy, bilateral prophylactic oophorectomy, prophylactic contralateral mastectomy and combinations of these interventions.
ResultsA 30 year-old breast cancer patient with BRCA mutations could gain
DiscussionAggressive secondary cancer prevention measures, particularly prophylactic contralateral mastectomy, can add up to 2 years to the life expectancy of young breast cancer patients who test positive for BRCA1 or BRCA2 mutations. Women should discuss strategies of how they prefer to prevent secondary cancer with their physicians. It is important to understand that each strategy has risks and benefits.