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Professor Kelly Metcalf. Credit: Horst Herget
A study conducted jointly by Kelly Metcalfe, professor at the Lawrence Bloomberg School of Nursing, and researchers at the Familial Breast Cancer Research Unit at Women’s University Hospital, shows the effectiveness of risk-reducing mastectomy (RRM) in women with BRCA1 or BRCA2 gene mutations. was found to be significantly higher. Your risk of being diagnosed with breast cancer is reduced and your chances of death are lower.
the study, Published in British Cancer Journalinvestigated the impact of RRM on mortality among women with pathogenic variants but not diagnosed with cancer.To date, he has only one other study Published by Dutch researchers It investigates the impact of RRM on mortality and quantifies the benefits associated with women.
“The decision to have a mastectomy to reduce risk is often difficult for women. The more evidence we can provide women with when making that decision, the better their care plan will be. We can get more information,” Metcalf said. She also serves as a senior researcher at the Women’s University Research Institute.
Women with inherited BRCA1 or BRCA2 mutations have an 80% lifetime risk of developing breast cancer. Research shows that RRM reduces the risk of breast cancer by 90 per cent, and in Canada, 30 per cent of women with pathogenic variants choose this procedure. Metcalfe says this is one of her most effective ways to prevent breast cancer in women with this risk profile.
Through a pseudo-randomized trial, Metcalf and his team followed over 1,600 participants from registries of women with pathogenic BRCA 1/2 mutations in nine countries for six years, and found that half of the women There was a risk. Reduce mastectomies.
At the end of the study, there were 20 cases of breast cancer and 2 deaths in the RRM group, and 100 cases of breast cancer and 7 deaths in the control group. RRM reduced the risk of breast cancer by 80%, and his chance of dying from breast cancer after 15 years of risk-reducing mastectomy was less than 1%.
“Although this study found no significant difference in the number of deaths between the two groups, we found that reducing the risk of mastectomy significantly lowers the risk of developing breast cancer,” Metcalf said. says.
Metcalfe points out that following these participants over a longer period of time will provide more evidence to accurately assess the true risk of death and highlight the benefits associated with this type of surgery. .
“With adequate breast cancer screening now in place, including breast MRI, surgery is only offered as an option, not a recommendation,” Metcalf says. “However, as more studies are conducted to assess women’s trajectories and risk factors after RRM, we will know whether these guidelines need to change in the future.”
For more information:
Kelly Metcalfe et al, Risk-reducing mastectomy and breast cancer mortality in women with BRCA1 or BRCA2 pathogenic variants: an international analysis, British Cancer Journal (2023). DOI: 10.1038/s41416-023-02503-8