The results pose new questions regarding treatment options for women
For many women under 40 with breast cancer, surgery to remove the cancerous lump and accompanying radiation seem the best way to get rid of the disease and preserve the natural breast. But for women who carry a damaged version of BRCA1 or BRCA2, genes predisposing them to breast cancer, such treatment may not be enough. Researchers at Jefferson Medical College have found that such women have a greater risk of either relapsing or developing new tumors years later than those women who receive a lumpectomy and radiation therapy but don't carry one of these genes.
As a result, says Bruce Turner, M.D., Ph.D., assistant professor of radiation oncology at Thomas Jefferson University in Philadelphia and a member of Jefferson's Kimmel Cancer Center, who led the work, women and physicians may want to rethink their treatment options.
"These findings suggest that a woman who has a mutation in BRCA1 or BRCA2 who is treated with breast-conserving therapy not only has a high risk of local recurrence--40 percent according to our study--but also a high risk of developing breast cancer in the other breast as well," Dr. Turner says.
"Our data suggest that breast-conserving therapy may not be the most optimal treatment for breast cancer patients with BRCA1 or BRCA2 mutations who want to reduce the risk of locally recurrent breast cancer."
Dr. Turner and colleagues at Yale University and Myriad Genetics report their findings in the October issue of the Journal of Clinical Oncology.
Of 170,000 new breast cancer cases a year in U.S. women, about 10 percent--17,000 women--are under 40. Some 10 to 15 percent of those women (2,000) carry an altered BRCA1 or BRCA2 gene, and about 70 to 80 percent develop breast cancer.