Cancer discovery could cut need for radical surgery

About one in 1,000 women carries the genetic mutation known as BRCA1

Angelina Jolie: carries the BRCA1 mutation and said she had a double mastectomy to reduce her risks. Photograph: Reuters
Angelina Jolie: carries the BRCA1 mutation and said she had a double mastectomy to reduce her risks. Photograph: Reuters

Researchers at Queen’s University Belfast have made an important discovery that could reduce or eliminate the need for women at high risk of cancer to undergo radical surgery. The work also shows that it should be possible for these women to have children without increasing their risk of cancer.

About one in 1,000 women carries the genetic mutation known as BRCA1 that results in an 85 per cent higher risk of breast cancer and up to a 40 per cent risk of ovarian cancer. For this reason many women with the mutation decide to undergo surgery to remove their breasts and ovaries rather than risk cancer.

The plight of these women was highlighted last May when actor Angelina Jolie, who carries the BRCA1 mutation, said she had a double mastectomy to reduce her risks.

Such radical surgery may become obsolete following four years of work by scientists in Queens' centre for cancer research and cell biology. They discovered how the mutation causes the genetic damage in breast and ovarian tissues that can lead to cancer, and publish their findings this morning in Cancer Research .

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The work gives considerable hope to women with the mutation because there are known drugs already approved for human use that can lower the risk of cancer, the scientists said. The researchers are working to get a human trial under way within the next 12 months.


Oestrogen levels
The scientists, led by Dr Kienan Savage of Queen's, found high levels of the hormone oestrogen were causing damage in breast and ovarian tissues, leading to cancers. They discovered that the normal BRCA1 gene protects against cancer by controlling oestrogen breakdown products, clearing them away. But if a woman has the mutated gene the clearout doesn't happen, leading to more damage and ultimately cancer.

Patients would receive drugs that turn off oestrogen, but in turn causing the symptoms of menopause, Dr Savage said. But a woman could go off the drug, have a child and go back on it afterwards.

Dick Ahlstrom

Dick Ahlstrom

Dick Ahlstrom, a contributor to The Irish Times, is the newspaper's former Science Editor.