Annual
Screening for Breast Cancer May Not Be Enough for BRCA 1/2
Carriers
According to a recent article published in the journal Cancer,
annual screening for breast cancer in women with BRCA1/BRCA2
mutations may not be frequent enough to detect early breast
cancer.
Although breast cancer is a common cancer among women in
the United States, only approximately 5%-10% are known to
be caused by family genetics. Mutations within the BRCA1 and/or
BRCA2 genes are among the most commonly known genetic abnormalities
that are associated with the development of breast cancer.
Women with BRCA1/BRCA2 mutations have a 65% to 85% cumulative
lifetime risk of developing invasive breast cancer, and have
the option of intensive screening, preventive hormone therapy,
preventive oral contraceptive use or preventive surgery to
remove their breasts (mastectomy) in order to reduce the risk
of developing breast cancer. Researchers have been evaluating
different methods of screening (i.e. mammography vs. magnetic
resonance imaging vs. ultrasound, etc.), as well as the optimal
frequency of screening in women with BRCA mutations.
Researchers from Columbia University recently conducted a
small clinical study evaluating screening frequency in women
with BRCA mutations. This study included 13 women who were
followed at the university between 1995 and 2002 and underwent
annual mammograms. During this time, 10 patients developed
breast cancer. Among the group of women who developed breast
cancer, 4 had cancer that was detected at the time of their
annual screening. However, the other 6 women had developed
breast cancer between annual screenings, with 50% having breast
cancer that had spread to their lymph nodes at the time of
detection. The average time of these 6 patients from their
last mammogram to the detection of cancer was 5.1 months.
The researchers concluded that annual screening with mammography
does not appear to be frequent enough in the detection of
breast cancer in women with BRCA mutations, as the majority
of breast cancers were detected only 5.1 months after their
last mammogram. Patients with BRCA1 and/or BRCA2 mutations
may wish to speak with their physician about scheduling their
screening for breast cancer, and the risks and benefits of
increasing the frequency of their mammograms. Patients with
BRCA mutations may also with to speak with their physician
about the risks and benefits of participating in a clinical
trial evaluating novel screening procedures for breast cancer.
Two sources of information regarding ongoing clinical trials
include the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com.
Personalized clinical trial searches are also performed by
cancerconsultants.com.
Reference: Blackwell S, Kain R, Remwell B, et la. Screening
frequency in BRCA mutation carriers. Cancer. 2004; 96:271-74.
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