According to the results of a study published in the Journal of Clinical Oncology, women who undergo prophylactic contralateral mastectomy (preventive removal of the opposite breast) after a first diagnosis of breast cancer and BRCA1/2 testing have a similar quality of life and distress level as women who do not undergo prophylactic contralateral mastectomy.

Inherited mutations in two genes-BRCA1 and BRCA2-have been found to greatly increase the lifetime risk of developing breast and ovarian cancer. Alterations in these genes can be passed down through either the mother’s or the father’s side of the family.

Among women with a BRCA1 or BRCA2 mutation, an important goal of research is to identify treatments, screening tools, and behavioral changes that can reduce the risk of developing breast cancer or improve early detection of cancer.

Women with a BRCA1 or BRCA2 mutation who develop breast cancer in one breast have a high risk of subsequently developing breast cancer in the other breast as well. One approach to managing this increased risk is to undergo prophylactic contralateral mastectomy (preventive removal of the opposite breast).

In order for women to make an informed decision about a prophylactic contralateral mastectomy, it is important that they understand the full range of potential risks and benefits, including the psychosocial effects of the procedure.

To evaluate the effects of prophylactic contralateral mastectomy on quality of life and level of distress, researchers conducted a study among 149 women with newly diagnosed ductal carcinoma in situ (DCIS) or Stage I to Stage IIIA breast cancer. All of the women had a 10% or greater chance of carrying a BRCA1 or BRCA2 mutation, and all underwent genetic testing.

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  • 15% of the study participants were found to have a BRCA1 or BRCA2 mutation. 54% of these women chose to undergo prophylactic contralateral mastectomy.
  • Of the women without a positive BRCA1 or BRCA2 test result, 25% chose to undergo a prophylactic contralateral mastectomy.
  • During the first year after surgery, quality of life and level of cancer-specific distress were similar in women who did and did not undergo a prophylactic contralateral mastectomy.

The researchers conclude that during the first year after surgery, quality of life is similar in women who do and do not choose to undergo a prophylactic contralateral mastectomy.

Reference: Tercyak KP, Peshkin BN, Brogan BM et al. Quality of Life After Contralateral Prophylactic Mastectomy in Newly Diagnosed High-Risk Breast Cancer Patients who Underwent BRCA1/2 Gene Testing. Journal of Clinical Oncology [early online publication]. December 11, 2006.

Related News:High Risk of Contralateral Breast Cancer Among Women with Hereditary Breast Cancer(3/22/2006)

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