Doubling Breast And Ovarian Cancer Screening Could Save Hundreds Of Lives
2018 Nov, 01 | Source: thetimes.co.uk
Twice as many women as are tested now should be screened for the “Angelina Jolie” gene that is linked to breast and ovarian cancer, a study suggests.
Researchers proposed new criteria that could save hundreds of lives a year after they found that the present screening criteria missed nearly half of patients with the BRCA variants.
Specific mutations on the BRCA1 and BRCA2 genes are associated with 5 to 10 per cent of breast cancer cases and put carriers at much higher risk than others. The variants are more common in certain populations, including Ashkenazi Jews and people of French-Canadian heritage, such as Jolie, 42, who had a double mastectomy after a positive BRCA test.
At present the NHS tests women who have had breast cancer diagnosed and who have a strong family history of breast or ovarian cancer. If they test positive their close relatives are also eligible for testing.
The team from the Royal Marsden and the Institute of Cancer Research used five simpler criteria to decide who should be tested for BRCA gene mutations. These did not depend on family history, of which many patients have limited knowledge, and instead tested more women who had cancer and their relatives.
They propose testing all women with ovarian cancer, breast cancer sufferers under 45, those under 60 with cancer of both breasts and those with aggressive “triple negative” breast cancer. When BRCA mutations are found, tests would be offered to the patient’s relatives.
In their study 1,020 people meeting the new criteria were tested and 110 had BRCA mutations. Under the existing criteria only 53 of the patients with mutations would have been tested — so half the mutations would have been missed. The researchers believe that the new approach could prevent more than 11,000 cases of cancer over ten years and save more than 2,000 lives. They say that it would also be cost- effective.
About 12,000 women a year are eligible for the gene tests. This would rise to 27,000 under the recommendations.
Breast cancer remains the most common form of cancer in women in Britain, with 50,000 diagnoses a year. Identifying whether breast cancer is caused by a BRCA gene mutation can improve decisions about treatment.
NHS England said the welcome research would be carefully reviewed.