Breast-Conserving Therapy for Hereditary Disease

Women with hereditary breast cancer treated with breast-conserving therapy have no increased risk for recurrence in the treated breast, according to a study published in the November 22, 2004, online issue of Cancer.

Breast-conserving therapy (BCT), consisting of lumpectomy and radiation, has been demonstrated in the past to be a safe, effective treatment for nonhereditary or sporadic forms of early breast cancer. However, the use of BCT for women with mutations in BRCA1 and BRCA2 genes has been controversial because of conflicting data about the increased risk of recurrence in the treated breast and the development of tumors in the untreated breast. In the new study, 87 women diagnosed with breast cancer and BRCA mutations were treated with BCT to evaluate their long-term cancer risks.

Investigators found no increase in the risk of cancer recurrence in the treated breast, compared to young women without mutations. Ten years after diagnosis, 13.6% of the women with a genetic mutation had experienced a recurrence similar to previously found rates for women with nonhereditary cancers treated with BCT. However, more than half of the women suffered a cancer-related event within 10 years of their diagnosis, including 37.6% who experienced a new cancer in the untreated breast.

"Breast-conserving treatment is a reasonable option for [women with BRCA mutations], and the indications for unilateral mastectomy should be the same for both hereditary and nonhereditary breast cancer,” concluded the authors. However, they caution that "discussion of bilateral mastectomy is warranted by the significant contralateral breast cancer risk.” The study was conducted by Mark Robson, M.D., and colleagues from Memorial Sloan-Kettering Cancer Center (New York, NY, USA).




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