Heading Breast Cancer Off at the Pass
In the study, 42 of the mastectomy patients also had surgery to remove their ovaries. In the comparison group -- all of whom had regular breast exams rather than mastectomy -- 32 women had their ovaries removed, Klijn and his colleagues report.
The Dutch researchers do not address the role that removal of the ovaries may have played in outcomes of their study. However, other researchers say removal of the ovaries can lower the risk of breast cancer because they produce estrogen. Researchers have found that estrogen contributes to development of breast tumors.
"If a woman has a family history of ... breast cancer and ovarian cancer and so is also at risk for ovarian cancer, she could have the ovaries removed," says David Euhus, MD, an assistant professor of cancer surgery at University of Texas Southwestern Medical Center at Dallas. "This lowers her risk of breast cancer by 47%. Women are often more willing to do this then to sacrifice a breast."
Euhus says that when his team assesses a woman for breast cancer risk factors, they use a number of variables such as which relatives had breast or ovarian tumors, at what ages the cancer developed, if and when the relatives died from the disease.
"We're very [number] oriented over here," he tells WebMD. "Only half of the generation in which the bad gene is running will ever get breast cancer. But if we're coming up with a 60, 70, 80% risk after we run the numbers through the computer, then [preventive] mastectomy is something they might want to consider."
However, Timothy Rebbeck, PhD, University of Pennsylvania associate professor of epidemiology, says that not enough is known about the part preventive mastectomies play in reducing breast cancer risk. He and his colleagues are currently conducting a study to compare the rates of breast cancer in women who decide to undergo the operation vs. those who don't.
"It is relevant to high risk women, but it may not be necessary," he tells WebMD. Still, he adds that preliminary results of his research are showing a significant risk reduction in those who have the operation.