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    Options for Breast Cancer Survivors With Genetic Mutations


    Roy Smith, MD, director of medical oversight for the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh, gave objective comment on the study to WebMD. In an interview, Smith says, "This study is entirely hypothetical and retrospective, but it is interesting. The assumptions about tamoxifen benefit are consistent with what I would predict based on our experience, but there's no substitute for clinical trials. Before I put a young woman with a BRCA mutation on five years of tamoxifen therapy, I'd want to be satisfied that it was going to be beneficial."

    Even though the analysis showed the greatest benefit was for women who underwent removal of their unaffected breast, Smith says, "I'm not sure that's a very useful observation because there are so few people doing it. The Holy Grail of breast cancer research remains finding a type of intervention that is not mutilating or high risk and that can be used early on. I don't think tamoxifen is that agent, but I think there are agents in studies and under development that seem quite promising."

    Vital Information:

    • Women who have BRCA mutations are at higher risk of developing breast cancer early in life and, once breast cancer has been diagnosed, developing second cancers.
    • Breast cancer patients who carry the mutation can increase their life expectancy with removal of the unaffected breast, removal of the ovaries, or taking tamoxifen therapy, according to a recent study.
    • Improvements in life expectancy were not as great in women whose cancer had spread to the lymph nodes or who were older.
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