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Breast cancer mutation may need early surgery

Young women with breast cancer associated with two genetic mutations may live years longer by having their healthy breast and their ovaries removed, a study found.

The study was an analysis of women with gene mutations, BRCA1 and BRCA2, which were identified a few years ago and are known to raise the risk of breast cancer so much that some women with the flaws have had their breast and ovaries removed before any sign of disease.

The study, led by Dr. Deborah Schrag and published in today's Journal of the American Medical Association, is a follow-up to a statistical analysis she and colleagues at the Dana-Farber Cancer Institute did on such pre-emptive surgery for healthy women. Schrag, a cancer specialist, is now at Memorial Sloan-Kettering Cancer Center in New York.

The new study, also based on a statistical analysis rather than on real patients, looks at women in early stages of breast cancer.

It does not advocate surgery. It notes that some women may be more concerned with sexual and reproductive function and self-image than with gaining a few years in life expectancy.

Between 5 percent and 10 percent of the estimated 175,000 cases of breast cancer diagnosed annually are linked to the mutations, according to the American Cancer Society.

A University of Pennsylvania study published last year found that healthy BRCA1 women who had had their ovaries removed could reduce the breast cancer risk by about 70 percent. But ovary removal induces menopause, which could put young women at risk for early development of brittle bones and heart disease.

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