'Drastic' surgery is best option against breast cancer says report

A controversial report by Queen's University researchers has said that the removal of the breasts and ovaries offers the best hope for women who have a high-risk cancer gene.

The report, published in The Lancet, brings together results from a series of international studies and claims that current cancer prevention techniques, such as screening or drug treatments, do not offer the same chance of survival as surgery for women who have a high risk cancer gene – known as BRCA1.

For women with a faulty BRCA1 who opt for a programme of screening, the lifetime risk of breast cancer is as high as 85%. The new report reveals that the removal of both breasts reduces the risk by at least 90%.

Lead researcher, Dr Paul Harkin said: "Surgery to remove a woman's breasts and ovaries may seem like a drastic step, but we have to remember that the women involved in these studies are at a very high risk of breast and ovarian cancer.

"However, it's important to emphasise that the choice lies with the women themselves. Some women decide to undergo surgery because it gives them peace of mind, others prefer to watch and wait. Either way it can be a traumatic experience and it's vital that women receive the best possible counselling to help them make their choices."

The risk of dying from the disease is put at between 10 and 20% over 20 years for women with the faulty gene. However, according to the report, surgery to remove both ovaries is thought to reduce the risk of ovarian cancer 24-fold and can also reduce the risk of breast cancer by half.

One study claims that women who had surgery to remove both breasts and ovaries gained an estimated 12 extra years of life compared to screening alone.

The report's lead author Dr Richard Kennedy said: "One reason for the failure of screening in this group of women is that tumours are often fast growing and can develop between screening appointments. And for this reason experts have feared that cancer patients who have a fault in BRCA1 would fare worse than other patients."

The researchers believe that between one in 500 and one in 1,000 women worldwide carry a faulty BRCA1 gene and, whilst a screening method to test for the gene is available, the researchers estimate that it fails to pick up 30 to 40% of BRCA1 mutations.


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