Study defines risk of developing breast cancer a second time

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Women diagnosed with breast cancer in one breast worry about whether the other breast is cancer-free and will remain so. Some choose to have the unaffected breast removed, called a prophylactic mastectomy, out of fear of another breast cancer diagnosis. Studies show most breast cancer patients would not experience any survival benefit from having a contralateral prophylactic mastectomy. But it is difficult to determine which patients should consider such action.

A new study, however, helps predict which women are at greater risk of developing cancer in the other breast and thus may want to consider prophylactic mastectomy. Researchers at the University of Texas M.D. Anderson Cancer Center studied 542 women who had breast cancer in one breast and who had both breasts removed. They found 5% of the women had breast cancer in the prophylactically removed breast and 15% had cells that were abnormal and could signify a higher risk for breast cancer. The researchers then looked for factors associated with contralateral breast cancer and found three independent factors:

• When the cancer cells had certain invasive characteristics
• When the cancer was present in more than one quadrant of the breast
• When the patient had a five-year Gail risk of 1.67 or greater. The Gail model is a breast cancer risk assessment tool that considers such factors as a patient’s age, medical history, race and other characteristics.

The study, published online today in the journal Cancer, also found that women age 50 and older at the time of the initial cancer diagnosis or who had additional moderate- or high-risk cells in their affected breast were likely to have abnormal cells in the other breast.

Researchers hope that women and their doctors can use the additional information to make more informed choices about the benefits of removing the unaffected breast.

-- Shari Roan