Protective mastectomies that preserve the nipple and surrounding skin prevent breast cancer as effectively as traditional mastectomies in women with the BRCA mutation, according to a major new study by the Mayo Clinic.
“This is pretty exciting because this operation is much more appealing to women because it gives a much better appearance than the traditional mastectomy and it seems to be a very safe way to offer a similar protection against breast cancer,” study lead author James Jakub, M.D., a breast surgeon at Mayo Clinic in Rochester, Minnesota, said in a video describing the research.
Researchers studied outcomes among 348 BCRA-positive women who had prophylactic nipple-sparing mastectomies performed at nine institutions between 1968 and 2013. The study included 203 women who had both breasts removed protectively, known as a bilateral mastectomy, and 145 patients who had one breast removed preventively after cancer occurred in the other breast.
None of the patients who had a bilateral nipple-sparing mastectomy developed breast cancer at any site after an average of three to five years of follow-up. Seven women died from breast cancer during follow-up, but in each of those cases the patient had a previous or concurrent breast cancer at the time of surgery and their stage IV disease was attributed to that cancer.
While nipple-sparing mastectomies have become far more common in recent years because they leave women with more natural-looking breasts than other mastectomies, some members of the medical community have hesitated to embrace the procedure for patients with BRCA mutations for fear that it would not adequately protect them. Women with BRCA mutations can have an 80 percent lifetime risk of breast cancer.
Results from the study, the largest of its kind, were presented at the annual meeting of the American Society of Breast Surgeons in Dallas in April.
“This offers patients and providers a lot of reassurance that this appears to be a safe way to go” said Dr. Jakob who calls the procedure “a very effective and safe way to prevent or significantly reduce a woman’s risk of getting a breast cancer even in the group of patients who are at the highest risk: those who have a genetic mutation.”
