Breast cancer genes also increase risks for older women

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TUESDAY, Feb. 28, 2023 (HealthDay News) — Although mutations of the BRCA1 or BRCA2 genes are associated with breast and ovarian cancer in younger women, those over age 50 continue to have a high risk of breast cancer. breast.

That’s true even if they didn’t have breast cancer before, new research shows.

“What is striking about our results is that breast and ovarian cancers were the most commonly seen cancers and this is concerning given that we know how to reduce the risk of cancer in women who have these genetic risk factors,” said Dr. study leader, Kelly Metcalfe. , professor at the faculty of nursing at the University of Toronto.

To study this, her team followed more than 2,200 women between the ages of 50 and 75 from 16 countries. These women knew they had a BRCA mutation and had no previous diagnosis of cancer.

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The risk of these women developing any type of cancer after age 50 was 49% for those with a BRCA1 mutation and 43% for those with a BRCA2 mutation.

It was even higher for those who had not had cancer risk reduction surgery, such as preventative removal of both breasts, ovaries and fallopian tubes. For these women, the risk was 77% for those with a BRCA1 mutation and 67% for those with a BRCA2 mutation.

About 15% of the women studied had undergone preventive bilateral mastectomy. About 43% had their ovaries and fallopian tubes removed before age 50.

These women had the lowest risk of any cancer at just 9%.

“Our review highlights the effectiveness of these risk-reducing surgeries and emphasizes the need for individuals, as well as healthcare professionals, to consider clinical guidelines and recommendations for their cancer risk, including how their genetics may affect them even at a later age.” , Metcalfe said in a university press release.

She noted that access to risk reduction surgery may be limited in some countries – a limitation of the study. The researchers did not assess whether or how often the women received genetic counseling.

“We don’t know whether our study participants received additional counseling about their increased risk of cancer as they age, nor can we determine why some of these women chose to forego preventive surgery before age 50,” Metcalfe said. . “However, it is important to point out that screening by itself reduces [death] increasing the chances of detecting cancer early does not reduce the risk of cancer occurring.”

There is no good screening method for ovarian cancer. National Comprehensive Cancer Network guidelines recommend that women with a BRCA1 mutation have their ovaries and fallopian tubes removed between ages 35 and 40, and those with a BRCA2 mutation between ages 40 and 45.

Metcalfe hopes that advances in genetic testing will help more women know their risks. Future studies will examine women’s decision making about surgery and their understanding of risk.

Low barriers to genetic testing will save lives, said Metcalfe, who hopes it will become a mainstay of cancer care in Canada. Regardless of family history, people can pay a small fee to be tested for BRCA1 and BRCA2 mutations through Screen Project Canada.

“It’s been over 25 years since clinical trials for BRCA1 and BRCA2 began in Canada and the United States, and we’ve come a long way in reducing the incidence of cancer, but not far enough,” said Metcalfe. “Most cancers resulting from these two genes are preventable, we need to give women the best chance of a cancer-free life.”

The results of the study were recently published in the journal Cancer.

The US Centers for Disease Control and Prevention has more information about the BRCA1 and BRCA2 genes.

SOURCE: University of Toronto, press release, February 24, 2023

Breast cancer genes also increase risks for older women

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