Study: Radical Preemptive Surgery for Breast Cancer Questioned

Dutch researchers say problems in the design of studies examining the value of preemptive surgery to prevent breast cancer by removing the breasts of high-risk women may have resulted in overestimating or underestimating the benefits of this therapy.

Women with certain mutations in the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 have an increased risk of developing breast and ovarian cancer, and previous studies have found that prophylactic removal of both breasts results in an 85 percent to 100 percent reduction in breast cancer risk.

But researchers from the Netherlands Cancer Institute in Amsterdam, writing in the Journal of the National Cancer Institute, said a variety of "biases" in the design of the studies "seem to result in an overestimation of the benefit from prophylactic surgery."

"As a consequence, cancer risk among women in the nonsurgery group may be overestimated, and this will result in an overestimation of the risk reduction after prophylactic surgery," the researchers said.

Biases in these studies need to given serious consideration and warrant critical discussion about their potential impact on results, according to the researchers.

"Only in this way can BRCA1/2 mutation carriers, clinical geneticists and treating physicians obtain more accurate information about the true extent of cancer risk reduction from prophylactic surgery," the researchers concluded.

"This valid estimate of risk reduction may become even more crucial in the future when data become available regarding the efficacy of new surveillance methods, such as magnetic resonance imaging, and new chemoprevention agents, such as raloxifene," the researchers wrote.

Other Sources: Journal of the National Cancer Institute