More women opt for mastectomies to beat cancer odds

WASHINGTON – They look healthy. But more and more women are getting mastectomies to counter a hidden risk.

These women carry a mutated gene — BRCA1 or BRCA2 — and that means they have up to an 85 percent increased lifetime risk of getting breast cancer.

Actress Angelina Jolie announced Tuesday that she had a preventative double mastectomy after learning that she was a carrier of BRCA1. While Jolie may be the best known woman who has undergone this surgery, she is hardly the only one.

“In the past 10 years, we are definitely seeing that more women are choosing to undergo preventative mastectomy,” says Dr. Eleni Tousimis, chief of breast surgery at Medstar Georgetown University Hospital and associate professor of surgery at Lombardi Cancer Center.

Tousimis says a big reason for this medical trend is the advent of tests to check for the faulty genes. And while women who test positive can opt for close monitoring instead of surgery, many decide removing their breasts while they are still healthy is the best option.

“The results are less disfiguring than they were in the past, say in their mother and grandmother’s era,” Tousimis says, explaining that the dramatic improvements in breast reconstruction is one reason more women chose to remove their breasts.

Another reason for the increase in surgery is attributed to memories of close relatives who battled breast cancer and lost.

“A lot of these women are mothers of very young children, just like Angelina Jolie, and they really want to be alive for their kids,” Tousimis says. “And they want to be aggressive and proactive and decrease their risk of developing future breast cancer by as much as possible.”

Studies have shown that a preventative mastectomy can cut a woman’s lifetime risk of getting breast cancer by over 90 percent, Tousimis says. However, it is not a total reduction because a thin layer of residual breast tissue remains after surgery.

That compares to a lifetime risk of about 12 percent for women who do not carry the mutated breast cancer gene.

Finding out whether a woman has BCRA gene mutations is simple, but expensive. The test involves either a blood or saliva sample which can cost several thousand dollars. The procedure is covered by some insurance, but there are strict guidelines on who should be tested.

The National Cancer Institute says testing for the gene is most necessary for women who have a strong family history of breast cancer or for women who have relatives who have had cancer and tested positive for the gene.

The mutated BRAC gene has also been linked a 50 percent increased lifetime risk of ovarian cancer. Therefore, women with a strong family history of ovarian cancer are also candidates for testing, especially Jewish women of Eastern European descent.

According to the National Cancer Institute, Jewish women of Eastern European descent are believed to have the highest rates of BRCA1 and BRCA2 mutations in the U.S.

For more information on the cancer risks associated with the BRCA1 and BRCA2 genes, visit the National Cancer Institute’s website and fact sheet.

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