BRCA Mutations Don't Spot All High-Risk Women

By Serena Gordon
HealthDay Reporter
Tuesday, May 6, 2008; 3:00 AM

Copyright © 2008 ScoutNews, LLC. All rights reserved.

MONDAY, May 5 (HealthDay News) -- In women who have been diagnosed with breast cancer, having a known mutation in the BRCA 1 or 2 genes raises the risk of a second cancer, and many of these women choose to have their second breast removed before that has a chance to happen.

However, new research suggests that women who don't have these genetic mutations may still face an increased risk of a second cancer, especially if they have a family history of breast cancer or atypical breast cells.

The study involved women with a family history of breast cancer, although only some had a BRCA mutation. The researchers found that the risk of cancer in the second breast was about 10 percent, regardless of whether the woman carried a BRCA mutation or not.

The findings were slated to be presented Sunday at the American Society of Breast Surgeons' annual meeting, in New York City.

The study suggests that "we may not have identified all of the genes associated with breast cancer," according to study author Dr. Shawna Willey, director of the Betty Lou Ourisman Breast Health Center at the Lombardi Cancer Center at Georgetown University in Washington D.C.

Many high-risk women may not be advised to have a prophylactic mastectomy even though it could be potentially lifesaving, she added.

"Having a prophylactic mastectomy should not be a knee-jerk reaction to a diagnosis of breast cancer. Women need to consider this data, as well as other data, and decide whether or not this is a measure they want to take," advised Willey. She said the findings may also add to the debate about which breast cancer patients should have sentinel lymph node biopsies.

"Prevention of secondary breast cancer is becoming increasingly important," said Dr. Julia Smith, director of the Lynne Cohen Breast Cancer Preventative Care Program at the New York University Cancer Institute in New York City. "Because of advances in treatment, it's possible that many younger women with breast cancer may live for decades, so we have to focus on what we can do to prevent a further problem."