BRCA-Positive Women May Need More Mammograms
Genetically High-Risk Women May Need More Frequent Breast Cancer Screening
April 12 , 2004 -- Annual mammograms may not be enough for
women who are genetically predisposed to breast cancer. A new study shows
nearly half of the women with the BRCA genetic mutation developed breast cancer
within six months of an annual mammogram.
Researchers say the findings show that more frequent breast
cancer screening may be needed for women with the BRCA mutation than currently
Annual breast cancer screening with mammography is recommended
for women over age 50, but there is no consensus regarding how frequently women
with BRCA mutations should be screened for breast cancer. However, most
guidelines do recommend starting screening in women with hereditary breast
cancer five to 10 years before the age of the youngest affected relative.
Women with the BRCA1 or BRCA2 genetic mutation have a 60%-85%
chance of developing breast cancer within their lifetime. Women who carry the
gene are often informed about how they can lower their risk, such as close
surveillance, preventive therapy using Tamoxifen, or prophylactic mastectomy
surgery to remove breast tissue.
More Mammograms for BCRA Carriers
In the study, researchers reviewed the charts of 13 women with
the BRCA genetic mutation who chose to follow close surveillance using annual
screening by mammography or ultrasound, monthly breast self-exam, a clinical
breast exam every 4-6 months, and consideration of breast MRI (magnetic
The results appear in the April 12 online edition of the
Three (23%) of the 13 women did not develop breast cancer. Four
(31%) of the 13 women developed breast cancer that was detected at the time of
the annual screening mammogram.
But six (46%) of the women developed breast cancers between
their annual mammograms. The breast cancers were detected an average of about
five months following their mammogram and the average size of the tumor was 1.7
centimeters. Four of these cancers were invasive and three had spread to the
Researchers say the radiologists that had performed the
mammograms on all six women who developed interval breast cancers had noted
that the women had dense breast tissue that might have interfered with the
accuracy of the results.
The study also showed that ultrasound imaging was able to
detect the breast cancers in three of the four women who had developed breast
cancer between screening intervals. None of the women underwent MRI breast
"These results suggest that strong consideration should be
given to screening BRCA-positive women at more frequent intervals and to using
additional imaging techniques, such as breast ultrasonography and/or breast
MRI, as a part of this screening process," write researcher Ian K.
Komenaka, MD, of Columbia-Presbyterian Medical Center in New York City, and