{"id":46592,"date":"2024-04-15T12:00:00","date_gmt":"2024-04-15T12:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2024\/brca-breast-ovarian-cancer-mri-surgery-fewer-deaths"},"modified":"2024-11-03T15:11:51","modified_gmt":"2024-11-03T15:11:51","slug":"studies-assess-impact-of-cancer-risk-reduction-measures-for-people-with-brca-changes","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/studies-assess-impact-of-cancer-risk-reduction-measures-for-people-with-brca-changes\/","title":{"rendered":"Studies Assess Impact of Cancer Risk-Reduction Measures for People with BRCA Changes"},"content":{"rendered":"

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People with harmful changes, or pathogenic variants, in the BRCA1<\/em> or BRCA2<\/em> genes have a substantially increased risk of breast and ovarian cancer.<\/p>\n

Credit: National Cancer Institute<\/p>\n<\/p><\/div>\n<\/figcaption><\/figure>\n<\/p><\/div>\n

For people in whom gene testing finds \u201charmful changes\u201d in the BRCA1<\/em> or BRCA2<\/em> genes, leading medical groups recommend that they take specific actions to lower their chances of being diagnosed with or dying from breast and ovarian cancer.<\/p>\n

Results from two recent large studies now add to findings from earlier studies suggesting that following those recommendations can reduce the risk of dying from these cancers.<\/p>\n

In one of the studies, people with harmful changes in BRCA1<\/a><\/em> who got periodic breast MRI<\/a> scans, known as MRI surveillance, were less likely to die of breast cancer in the ensuing years than those who did not<\/a>. The same benefit wasn’t seen in people with harmful BRCA2<\/a><\/em> changes, however.<\/p>\n

The second study analyzed the impact of surgery known as a risk-reducing bilateral salpingo-oophorectomy<\/a>, which involves removing both ovaries<\/a> and fallopian tubes<\/a>. Those with harmful BRCA1<\/em> or BRCA2<\/em> changes who had the surgery, the study found, had a lower risk of dying from ovarian cancer and breast cancer<\/a> than those who didn\u2019t.<\/p>\n

Results from both studies were published February 29 in JAMA Oncology<\/em>.<\/p>\n

\u201cThese studies show that [these] cancer risk management strategies \u2026 can save lives,\u201d wrote Meghna Trivedi, M.D., and Katrina Armstrong, M.D., of Columbia University Irving Medical Center in an editorial that accompanied both studies<\/a>.<\/p>\n

Nearly all participants in the studies were White, however, raising the question of what these results mean for people of other ethnic and racial backgrounds.<\/p>\n

\u201cWe have to be careful about how we interpret the results\u201d for people in these groups, said Goli Samimi, Ph.D., of NCI\u2019s Division of Cancer Prevention<\/a>, who was not involved in the study.<\/p>\n

\u201cHopefully [these findings] are the impetus to do similar studies that focus on enrolling a diverse population of participants,\u201d Dr. Samimi said.<\/p>\n

Recommendations for genetic testing, MRI surveillance versus reality<\/h2>\n

Inherited changes in a host of genes can increase cancer risk. Perhaps of most concern for breast and ovarian cancer are harmful changes (often called pathogenic variants) in BRCA1<\/em> and BRCA2<\/em>. <\/p>\n

For example, 60% to 70% of people with harmful BRCA1<\/em> or BRCA2<\/em> changes will be diagnosed with breast cancer by the time they\u2019re in their 70s, compared with only 13% of those who don\u2019t have such changes.<\/p>\n

Because of the substantial risk linked to these inherited genetic changes, leading cancer organizations recommend that people who have them consider taking measures to reduce the likelihood of developing or dying from either of these cancers, explained Tuya Pal, M.D., of the Vanderbilt-Ingram Comprehensive Cancer Center in Tennessee, a member of the study team. <\/p>\n

But experts on inherited cancers stress, however, that recommendations are one thing. Their use in the real world is another matter entirely. The barriers and challenges are numerous, Drs. Trivedi and Armstrong wrote. <\/p>\n

\u201cFirst and foremost, more must be done to increase the identification of\u201d people who have harmful BRCA1<\/em> and BRCA2<\/em> changes, in the form of more genetic testing<\/a>, they wrote. <\/p>\n

The study\u2019s lead investigator, Steven Narod, M.D., of Women\u2019s College Hospital in Toronto, agreed. Recent studies show that genetic testing among at-risk people is increasing. But the fact remains, Dr. Narod said, that \u201ctoo few people are getting tested.\u201d <\/p>\n

For those who are able to get tested, Dr. Pal stressed that it\u2019s critical to get counseling first by a provider with experience in genetics and cancer risk. Such counseling can help people understand what the different test results mean for them personally, including the possible risk reduction measures.<\/p>\n