Breast cancer detection and treatment have made great strides in recent years. One of the pillars that has allowed these advances is that the disease is now known more from the biological point of view.
We now know that a woman's risk of breast cancer increases significantly if a harmful mutation in the BRCA1 gene or BRCA2 is inherited. This risk can be detected by genetic testing.
Can all women with a history of breast cancer in your family have it?
A very thorough medical history is necessary to check if a patient is at risk. If there is a family predisposition, the type of cancer should be analyzed to assess the type of mutation that could occur. Genetic studies help determine if it is present or not. If the result is positive, the risk of developing breast cancer is higher than for the population average (between 40% and 85%), that is, between three and seven times greater than in the case of women who do not have that mutation.
Are these studies accessible?
The cost can be high and they are not available in the health sector, perhaps little by little they are more accessible, but normally we do it through research protocols.
What preventive measures can be taken if the risk of breast cancer is found to be high?
One of them is surgery, risk reducing or prophylactic mastectomy. That was the case of Angelina Jolie, her mother was found to have cancer and she was a carrier of a mutation. The actress did the study and confirmed that she was also a carrier of the mutation, she decided to have a mastectomy because of her probability of developing cancer.
Does prophylactic mastectomy guarantee that cancer will not develop?
No, surgery is risk reducing, it does not prevent 100% the disease. In medicine there is always a range of risk, even in bilateral mastectomy there is always some breast tissue left, although it is rare and rare that cancer occurs after a mastectomy, it can happen.
In all cases of genetic predisposition to develop breast cancer, should a mastectomy be performed?
Only if certain genes are present, it depends on how much they are associated with breast cancer, each one has its own particularity. Mastectomy is not the only form of prevention, it can also be closely followed by radiological studies, such as MRI and mammography every six months to one year. That way you can see the breast better and study it in shorter periods. The last option is to take tamoxifen to interfere with the mechanism of action of estrogens and thereby the possibility of developing breast cancer.