26 May 2014

Double mastectomy: measure seven times…

Women were warned about the impracticability of following Jolie's example

Copper news from the University of Michigan: Most women who have double mastectomy don't need it, U-M study finds

American scientists found that approximately 70% of women who underwent a double mastectomy (after the discovery of a malignant tumor in one of them), the risk of developing cancer in the removed healthy gland was extremely small. The results of the study are published in the journal JAMA Surgery (Hawley et al., Social and Clinical Determinants of Contralateral Prophylactic Mastectomy).

Previous studies have shown that in recent years there has been an increased tendency to remove both mammary glands after the diagnosis of cancer. The popularity of such an aggressive treatment method raises the question of whether such treatment is excessive. Contralateral preventive mastectomy is an operation to remove both mammary glands, which entails various complications and a long recovery period. Such an operation does not eliminate the need for radiation or chemotherapy courses, which reduce the risk of relapse of the disease. In addition, many women after mastectomy go for surgical breast reconstruction.

Scientists from the Cancer Center at the University of Michigan studied the data of about 1.5 thousand women who were treated for breast cancer and had no relapses. Of these, 8% underwent a double mastectomy, the rest of the patients chose the removal of one breast or organ-preserving surgery to remove the tumor (lumpectomy). In general, about three quarters of patients reported that they were concerned about the fear of relapse of the disease. Those who decided to remove both mammary glands most often expressed their concern about this. At the same time, according to statistics, in most cases, cancer of one breast does not increase the likelihood of developing cancer in another gland.

In addition to analyzing the choice of treatment method, the researchers conducted genetic testing of patients for predisposition to breast cancer and studied family history to find out whether there were cases of breast or ovarian cancer in their families. Women who have mutations in the BRCA1 and BRCA2 genes (as, for example, in the case of Angelina Jolie), and those who have already had cases of breast cancer in their family, are recommended to have a double mastextomy, since they have a very high risk of developing cancer in another breast. However, only 10% of all patients with such a diagnosis fall into this category, and the rest have an extremely low probability.

As the results of the study showed, 70% of patients who chose contralateral preventive mastectomy had no mutations in the BRCA1 and BRCA2 genes or an aggravating family history, and many of them would have had enough to perform an organ-preserving operation. However, the women's concern about the possibility of a recurrence of breast cancer turned out to be so strong that they decided to remove both mammary glands.

According to scientists, it is necessary to explain in more detail to patients the advantages and disadvantages of double mastectomy. "Women who do not have oncogenic mutations or cases of breast cancer in the family, apparently, there is no need to remove a healthy gland," says the main author of the study Sarah Hawley (Sarah Hawley).

Portal "Eternal youth" http://vechnayamolodost.ru26.005.2014

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