NEW YORK (Reuters Health), Mar 3 - Prophylactic mastectomy is highly effective in preventing invasive breast cancer in BRCA1 and BRCA2 mutation carriers, Dutch researchers report in the March issue of the Annals of Surgery.
"BRCA gene mutation carriers can be confronted with the almost impossible decision to do or not to do prophylactic mastectomy as secondary prevention of breast cancer," lead author Dr. Reinoutje Kaas told Reuters Health by e-mail. "Perhaps our research can help the carriers who are uncomfortable with screening."
Dr. Kaas and colleagues at The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, studied breast tissue from 147 asymptomatic carriers (100 BRCA1, 47 BRCA2) who had bilateral mastectomy and 107 symptomatic carriers (79 BRCA1, 28 BRCA2) who had contralateral mastectomy after a mean cancer-free interval of 3.6 years.
One asymptomatic BRCA2 carrier had an occult 5 mm invasive ductal carcinoma, and another two had ductal carcinoma in situ (DCIS). Four asymptomatic BRCA1 carriers also had DCIS.
Among the symptomatic women, two BRCA1 carriers and three BRCA2 carriers had DCIS in the contralateral breast, but none had an invasive cancer.
None of the asymptomatic carriers developed breast cancer during a postprophylactic follow-up period of 778 women-years. The symptomatic carriers had only one invasive breast cancer detected during 580 women-years.
Prophylactic mastectomy "is safe and highly effective in preventing breast cancer," Dr. Kaas said. By contrast, "screening does not lower the life-long risk and is not perfect: in 4% of the asymptomatic carriers the beginning of a breast cancer was found, undetected by mammography and MRI."
By David Douglas
Ann Surg 2010;251:494-498.
Last Updated: 2010-03-02 19:38:24 -0400 (Reuters Health)
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![Overview of the study design. (A) The fully automated deep learning framework was developed to estimate body composition (BC) (defined as subcutaneous adipose tissue [SAT] in liters; visceral adipose tissue [VAT] in liters; skeletal muscle [SM] in liters; SM fat fraction [SMFF] as a percentage; and intramuscular adipose tissue [IMAT] in deciliters) from MRI. The fully automated framework comprised one model (model 1) to quantify different BC measures (SAT, VAT, SM, SMFF, and IMAT) as three-dimensional (3D) measures from whole-body MRI scans. The second model (model 2) was trained to identify standardized anatomic landmarks along the craniocaudal body axis (z coordinate field), which allowed for subdividing the whole-body measures into different subregions typically examined on clinical routine MRI scans (chest, abdomen, and pelvis). (B) BC was quantified from whole-body MRI in over 66,000 individuals from two large population-based cohort studies, the UK Biobank (UKB) (36,317 individuals) and the German National Cohort (NAKO) (30,291 individuals). Bar graphs show age distribution by sex and cohort. BMI = body mass index. (C) After the performance assessment of the fully automated framework, the change in BC measures, distributions, and profiles across age decades were investigated. Age-, sex-, and height-adjusted body composition reference curves were calculated and made publicly available in a web-based z-score calculator (https://circ-ml.github.io).](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/05/body-comp.XgAjTfPj1W.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
