NEW YORK, Oct 07 (Reuters Health) -- Young breast cancer patients who carry one of two genes linked to breast cancer and opt for breast-conserving therapy have a high risk of developing another malignant breast tumor, either at the same site or in the other breast, report US researchers.
The findings suggest that these women may benefit more from aggressive surgery rather than lumpectomy and radiation, according to Dr. Bruce Turner of Thomas Jefferson University in Philadelphia, Pennsylvania, and colleagues. Their report is published in the October issue of the Journal of Clinical Oncology.
By performing genetic studies in 52 women, the researchers identified BRCA1 or BRCA2 mutations in 40% of the women under age 40 with recurrent cancer in the same breast, compared with only 5% of such women over the age of 40, the results indicate.
The team also found that is took almost twice as long -- 8 years versus about 5 years -- for breast cancer to recur in the women carrying the BRCA genes than in those who did not carry the genes. However, examination of the tumors suggests that in the women carrying the genes, these tumors are not the previous cancer returning but completely new tumors.
All patients who had BRCA1 or BRCA2 mutations "underwent successful surgical salvage treatment with mastectomy at the time of (recurrence) and remain alive without evidence of further progression, (an average of) 7.7 years after breast relapse," the investigators report.
The researchers suggest that testing for the cancer genes may be useful when deciding on appropriate treatment. The data might lead breast cancer patients with BRCA1/2 mutations to consider mastectomy over breast-conserving therapy in order to reduce their high risk of recurrence.
"If you told a woman with a damaged BRCA1 or BRCA2 gene that 'in 9 years, 40% to 50% of patients like you are going to have a new breast cancer, and you may need a mastectomy,' then you'd have to ask her, 'would you rather have the lumpectomy and 7 weeks of radiation or would you rather have the mastectomy now and reduce the risk of recurrent disease?'" explained Turner in a statement.
But he emphasized that more study is needed to confirm the findings. "It makes sense that by removing 90% to 95% of the breast cancer cells by mastectomy, the future risk of breast cancer is significantly reduced," said Turner. "But more definitive data is needed before we can justify this recommendation."
