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Friday, 27 September, 2002, 03:53 GMT 04:53 UK
Breast removal 'best cancer hope'
Screening does not always find fast-growing tumours, scientists said.
Screening does not always find fast-growing tumours
Research carried out by scientists in Belfast has suggested the removal of breasts and ovaries offers the best hope for women who have a high risk cancer gene.

A report written at Queen's University in Belfast has concluded that screening and drug treatments are not always the most effective way to combat these cancers.

Its authors said as many as one in 500 women could have inherited a mutation in the breast cancer 1 gene and for them the lifetime risk of that is as high as 85%.

Women who have a family history of breast or ovarian cancer are particularly at risk.

The report suggests that for them the removal of both breasts can reduce that risk by 90%.

Removal of both ovaries would drastically cut the chance of both ovarian and breast cancer.

'Drastic measure'

Lead researcher Dr Paul Harkin from Queen's, said: "Surgery to remove a woman's breasts and ovaries may seem like a drastic step but we have to remember that the women involved in these studies are at a very high risk of breast and ovarian cancer."

The researchers carried out a review of international studies on women who carry a mutation in the BRCA1 gene.

The gene normally helps mend damaged genetic material but women with the faulty version have a lifetime risk of breast cancer of around 50% to 85% and a risk of ovarian cancer of 15% to 60%.

The researchers said about 31,250 women in the UK could have the gene.

Women found to have the faulty gene have so far been offered regular screening, given drugs such as Tamoxifen or have their breasts and ovaries removed as preventative measures.

However, the removal or healthy breasts and ovaries removal has been a controversial issue.

'Fast-growing tumours'

The research, published in the Lancet on Friday, includes analysis of one study which appeared to show that women who had surgery to remove both breasts and ovaries gained an estimated 12 extra years of life compared with screening alone.

The report's lead author Dr Richard Kennedy, also from Queen's, said: "One reason for the failure of screening in this group of women is that tumours are often fast growing and can develop between screening appointments."

He said there could also be problems detecting ovarian cancer from abdominal ultrasound screening."

'Choice'

However, Dr Harkin said it was important to stress that the choice lay with individual women and, while some may opt for surgery, once past child-bearing age, others might prefer to rely on regular screening.

The review also looked at the impact of preventative surgery and found it could lead to depression for some women and have an impact on sexuality.

However, other women showed no adverse effects.

The faulty BRCA1 gene is more common in some populations than others, for example in Jewish women of Eastern European origin.

Screening for the gene mutation is recommended for women with three close relatives from the same side of the family diagnosed with breast or ovarian cancer at any age.

 WATCH/LISTEN
 ON THIS STORY
BBC NI's Ronan Breen:
"The choice is stark: surgery or wait and see"
Doctor Paul Harkin, author of report:
"Of the two options surgery gives the greatest reduction in risk"
See also:

08 Feb 02 | Health
03 Sep 02 | Health
22 Apr 02 | Health
01 Oct 01 | Health
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