Like Angelina Jolie, one in 800 women in France is the victim of a genetic anomaly that predisposes to breast cancer. The BRCA1 or BRCA2 genes, discovered in early 1990, induce a risk of approximately 70% of breast cancer and 40% of ovarian cancer before the age of 70. The BRCA2 gene increases these risks by 50% and 20%.
The genetic test to identify these two genes is extremely complicated and expensive. They are generally carried out in women who are already sick and have characteristics that suggest a genetic risk. If the tests confirm the mutation, the family circle close to the patient will be followed.
For these women at risk, three options are possible: preventive ablation and increased screening (annual mammography, ultrasound and MRI). “About 90% of these women choose surveillance“says Dr. Suzette Delaloge, oncologist.
At the National Cancer Institute (InCA), specialists say that when there is a clearly established genetic risk a third option is possible. This is ovariectomy, that is, the removal of the ovaries and tubes. This operation roughly halves the risk of breast cancer.
In addition, a recent study published in the American journal The Jama shows that preventive removal of the breasts and / or ovaries reduces the risk of cancer and death. “The researchers were able to show that none of the 247 women who underwent a prophylactic mastectomy presented with breast cancer during the three years of medical follow-up while there were 98 cases among the 1372 women. who had not had such ablation, unlike the non-operated women, 7% of whom had a breast tumor during the three years of surveillance “.
Nevertheless, mastectomy remains a poorly chosen solution because it is often traumatic: “the scar remains visible, there is a loss of sensitivity of the breast and the breast prostheses must be changed every 10 years” affirms Dr Suzette Delaloge.
” In France, the percentage of women carrying a genetic mutation predisposing to breast cancer and choosing to undergo a bilateral mastectomy is around 5%“, explains Professor Dominique Stoppa-Lyonnet, an undisputed specialist in the genetics of breast cancer (Institut Curie, Paris) in Figaro Santé. The media coverage of the medical case of Angelina Jolie will perhaps make it possible to” popularize »This method of prevention.
In addition, it is recommended to carry out a breast ablation as soon as possible, from the thirties. “It is only really recommended for women whose family circle died early from breast cancer. For others, it’s just a possible option. In all cases, this choice must be made with psychological support and the support of the spouse.t “explains Dr Suzette Delaloge, head of the Breast Pathology Committee at the Gustave Roussy Cancer Institute.
