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A very unique study was just published in the journal Cancer regarding healthy women who have undergone breast reduction procedures for cosmetic reasons. Dr. Louise Brinton of the National Cancer Institute in Bethesda, Maryland and colleagues noticed that women who have undergone such procedures seemed to have a substantially lower risk of eventually developing breast cancer. Yet the reasons remained unclear. They therefore set out to determine if one specific factor, the actual amount of breast tissue removed, had a direct and proportional influence on eventual breast cancer risk. Brinton’s team analyzed the medical records of more than 31,000 Swedish women who had undergone breast reduction operations. They found that 137 of the women in the study eventually developed breast cancer. These cancer patients were then compared with 422 women who underwent the same procedure but did not develop the disease. Environmental, lifestyle and other factors that might have influenced breast cancer risk were identified and eliminated. The researchers found that a woman’s age at the time of her breast reduction surgery had no impact on her eventual risk of breast cancer. However, the actual amount of tissue removed as part of the procedure apparently did make a difference—the more breast tissue that was removed, the lower the eventual risk of disease. For those women who had at least 800 grams of tissue removed, their breast cancer risk was 76 percent lower than in women who had half as much breast tissue removed. The risk reduction was even greater for women who had as much as 1,600 grams removed. The researchers concluded that as more “potential cancer starting points” are removed, a woman’s breast cancer risk is consequently lessened.“ The finding that breast cancer risk was reduced in proportion to the amount of tissue removed should be reassuring to women who are considering breast reduction procedures,” they wrote. They added that their findings should also be validating for women who are considering a bilateral prophylactic mastectomy because of their strong genetic predisposition to breast cancer. A bilateral prophylactic mastectomy is a radical preventive measure involving the removal of both breasts when there is currently no sign of breast cancer. Just as the removal of more tissue in a breast reduction procedure results in a proportionally lower breast cancer risk, they noted, a bilateral prophylactic mastectomy should therefore confer an even greater preventive effect. And that indeed appears to be the case. For example, in a presentation at the annual meeting of the American Association for Cancer Research, Dr. Lynn Hartmann of the Mayo Clinic reported on a study which found that prophylactic bilateral mastectomy can reduce the risk of breast cancer by up to 90 percent in women at high risk for the disease.
SOURCES: Cancer, February 1, 2001; 91:478-483
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