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Breast cancer

Updated 12 February 2014

Angelina's double mastectomy safest choice for some women

Scientists have found that having a double mastectomy, like Angelina Jolie had, will cut your risk of dying from breast cancer in half if you have the BRCA gene mutation.

Women diagnosed with an inherited form of breast cancer might halve their risk of dying of the disease if they remove both breasts, a new study suggests.

Conclusions may be premature

The research, published in the journal BMJ, is the first evidence that shows having a so-called bilateral mastectomy actually saves the lives of women with early stage breast cancer and mutations in their BRCA genes.

But some doctors not involved with the study said the conclusions may be a bit premature.

Angelina Jolie brought new attention to gene testing for breast cancer in May 2013 when she announced she carried a mutation in her BRCA1 gene and was removing both breasts with the hope of avoiding her mother's fate.

More aggressive forms of cancer

On average, about 12 percent of women will get breast cancer over the course of their lives. But for women who carry BRCA mutations, the lifetime risk jumps to 60 percent to 70 percent, according to background information included in the study. 

Such mutations are rare, however. They're estimated to account for about 5 percent to 10 percent of all breast cancers, according to the study.

Mutations in their genes

The new study traced the cancer histories of nearly 400 women with stage 1 and stage 2 breast cancer who were diagnosed between 1977 and 2009. 

Over the course of the study, 79 women died of breast cancer – 61 in the group that had only one breast removed and 18 in the group that had both breasts removed.

Cured of breast cancer

Narod said his study underscores the importance of genetic testing, especially for women who are diagnosed at a young age or who have a strong family history of the disease. For them, a positive genetic test should help guide treatment decisions.

"We get a lot of women who are diagnosed, and they're young and they get sent to us for fast-turnaround BRCA testing so they can make treatment decisions," said Dr. Mary Daly, chairwoman of cancer genetics at Fox Chase Cancer Centre in Philadelphia. 

Removing other breast later

Beyond removal of the breasts, Daly said there are other treatments that can help women with BRCA mutations. Those include removal of the ovaries, which also decreases the chances of breast cancer; preventive medications such as tamoxifen; and intensive monitoring with yearly mammograms and MRIs.

Read: What you should know about treating breast cancer with surgery 

Should you get tested?

Dr Owen Nosworthy, a Specialist Physician/Medical Oncologist at Wits Donald Gordon Medical Centre says that Angelina’s case is “rare and exceptional” as the gene responsible, BRCA1, is actually very rare and he cautions against women rushing out to get tested.

The genetic test for BRCA1 is not freely available and requires that your doctor refers you to a specialist who will then take your blood to get tested.

The average woman is unlikely to test positive for it, however, and he wouldn't recommend that many women do this unless they have a family history of breast cancer.

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Your mastectomy options

 

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Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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