A new study indicates that expanding access to preventative breast removal surgeries could prevent thousands of breast cancer cases annually in the UK.
Risk-reducing mastectomies (RRM) are currently limited to women with high-risk genes like BRCA1, BRCA2, and PALB2.
However, researchers from Queen Mary University of London and the London School of Hygiene and Tropical Medicine (LSHTM) argue that women with other genetic variants—including ATM, CHEK2, RAD51C, and RAD51D—could also benefit, especially if they have additional risk factors such as a family history of breast cancer, limited breastfeeding, dense breast tissue, or fewer children.
The study’s economic evaluation found that broadening RRM eligibility would be cost-effective. It estimates that if all women aged 30 to 55 with a 35% or higher lifetime risk of breast cancer underwent RRM, approximately 6,538 cases could be prevented each year—about 11% of the 59,000 annual breast cancer diagnoses in UK women.
Identifying eligible women with these lesser-known genes could be achieved through “cascade testing,” which offers genetic screenings to family members of those already identified as carriers.
Professor Ranjit Manchanda, a gynaecological oncology professor at Queen Mary and one of the study’s authors, noted that this is the first time clear risk criteria for RRM have been defined. “Our results could expand access to mastectomy beyond patients with BRCA1/2 or PALB2 genes, who are traditionally offered this,” he said.
Louise Grimsdell, a senior clinical nurse specialist at Breast Cancer Now, emphasized that surgery is not the only option. “Each woman must be offered all suitable risk-management choices, including screening and medication,” she said, adding that the decision is deeply personal and involves emotional and physical considerations. She also called for urgent action to address long wait times for those choosing RRM.
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