BRCA mutations are a significant factor in assessing breast cancer risk
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The article "Big Rise Found in Preventive Mastectomies" (Oct. 10) reports that women are choosing to have healthy breasts removed possibly because they are unaware of advances in treatment and screening or are influenced by celebrities such as Christina Applegate. The article did not make clear the huge difference in risk between women who have been diagnosed with BRCA mutations or who have strong family histories of breast cancer and those whose cancer is most likely sporadic.
Studies have found that women with BRCA mutations have a lifetime risk of getting breast cancer that is between 55 and 85 percent and that the risk of a second cancer developing in the opposite breast within 10 years of an initial diagnosis is between 37 and 40 percent. The risk for a second breast cancer among women who develop sporadic cancer is about 10 percent. This difference in risk makes preventive surgery a rational choice for women with BRCA mutations. Furthermore, women with a BRCA1 mutation are at a higher risk for getting triple negative breast cancers which do not respond to many of the new treatments available.
I, like Christina Applegate, have a BRCA1 mutation. I did very thorough research about my risk of developing cancer and the likelihood that regular MRIs and mammograms might miss a cancer which would then require chemotherapy and/or radiation or which might in the end be fatal. While it is true that studies of mutation carriers have not yet shown a statistically significant improvement in mortality for those having preventive mastectomies versus those doing regular screening with both MRIs and mammograms, I chose the preventive surgery because I was able to lower my risk to something under 10 percent. I preferred not to have the very likely threat of chemo and radiation, even if they are often successful, hanging over me.
ROBIN F. KARLIN
The writer is co-coordinator of Pittsburgh FORCE (Facing Our Risk of Cancer Empowered) (www.facingourrisk.org).
First Published October 22, 2012 12:00 am