COMMENTARY

BRCA: Best Advice for Patients Who Worry

Sandra Adamson Fryhofer, MD

Disclosures

May 28, 2013

In This Article

Preventive Surgery

Preventive or prophylactic surgery is also an option, but it's no guarantee. Although as much at-risk tissue is removed as possible, cancer could still develop in any remaining tissue. That said, prophylactic mastectomy cuts breast cancer risk by 90% in BRCA mutation carriers. A 1999 New England Journal of Medicine study also demonstrated a 90% reduction in breast cancer incidence in women with a family history of breast cancer.[4]Prophylactic salpingo-oophorectomy -- removal of healthy fallopian tubes and ovaries -- can provide double cancer protection. It cuts breast cancer risk by 50% in premenopausal women and cuts ovarian cancer risk by 90% in both pre- and postmenopausal women.

Of interest, it was recently reported that a man in the United Kingdom had what may be the first prophylactic prostatectomy because of a positive BRCA finding. This 53-year-old man is married and has several children. He also has several family members with prostate and breast cancer. After finding out that he had a BRCA2 mutation, he decided to be proactive and have his prostate removed.[5]

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