After treatment, young women with breast cancer who carry a human gene that produces tumour suppressor proteins, BRCA mutation, have the same chances of survival as women without the mutation…

The cohort study was published in The Lancet Oncology journal on 11 January 2018.

BRCA mutations occur in either the BRCA1 or BRCA2 gene, and are inherited. These mutations place women at a greater risk of breast and ovarian cancers, with 45-90% of women with the mutation developing breast cancer during their lifetime, compared to roughly 12,5% of women developing breast cancer in their lifetime overall in the UK.

Largest study of kind

“Our study is the largest of its kind, and our findings suggest that younger women with breast cancer who have a BRCA mutation have similar survival to women who do not carry the mutation after receiving treatment,” says Professor Diana Eccles, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK.

Double mastectomies, chemotherapy

“Women diagnosed with early breast cancer who carry a BRCA mutation are often offered double mastectomies soon after their diagnosis or chemotherapy treatment. However, our findings suggest that this surgery does not have to be immediately undertaken along with the other treatment.

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In the longer term, risk-reducing surgery should be discussed as an option for BRCA1 mutation carriers in particular, to minimise their future risk of developing a new breast or ovarian cancer.

Decisions about timing of additional surgery to reduce future cancer risks should take into account patient prognosis after their first cancer, and their personal preferences,” adds Professor Eccles.

Secondary cancers

Writing in a linked Comment, Professor Peter Fasching, Friedrich-Alexander University Erlangen-Nuremberg, Germany, says: “Understanding prognosis in young patients is important because patients with BRCA mutations are at increased risk of developing specific conditions, such as secondary cancers, including ovarian cancer, contralateral breast cancer, and de novo breast cancer in the same breast.

These risks determine treatment, and knowing that BRCA1 or BRCA2 mutations do not result in a different prognosis might change the therapeutic approach for these risks…,” concludes Professor Fasching.

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