Preventive mastectomy: specialist consultation is required
Jolie showed prevention
Nadezhda Markina
"Newspaper.En" with the help of a specialist in the molecular diagnosis of cancer, he understands whether women with a hereditary predisposition to breast cancer should decide on a radical measure – preventive mastectomy. The verdict of a specialist is worth it.
The news that blew up the world – Angelina Jolie, a recognized sex symbol and the subject of dreams of men on the planet, removed her breasts. Knowing about her genetic predisposition to breast cancer, the actress chose to go for surgery, but not to put herself at risk of a deadly disease, and her loved ones at risk of losing her wife and mother.
Mastectomy consists in the surgical removal of the breast itself and adipose tissue, and also, depending on the option, includes the removal of the small and /or large pectoral muscles. Depending on the indications, mastectomy options may be more or less radical. Usually, women who have been diagnosed with a malignant tumor of the mammary glands go to surgery, less often – with purulent inflammation of the breast. But some patients decide to undergo surgery for preventive purposes.
They will learn about the risk of getting breast cancer based on the results of DNA testing. Predisposition to this disease may be hereditary. To date, experts believe that most cases of hereditary breast cancer are associated with the BRCA1 and BRCA2 genes, or rather, with their mutations. By the way, these genes are associated with a predisposition not only to breast cancer, but also to ovarian cancer.
The BRCA1 and BRCA2 genes themselves normally protect the mammary gland from cancer, as they encode a protein that controls the growth and reproduction of cells. If a mutation occurs in the gene, or rather, if two alleles of this gene on both chromosomes turn out to be mutant, the protein will not be produced and the cells will start rampant reproduction.
About what the real risks are and whether they are worth the loss of an essential attribute of female beauty, "the newspaper.Ru" was told by Evgeny Imyanitov, MD, Professor, Head of the Department of Tumor Growth Biology at the N. N. Petrov Research Institute of Oncology.
– How many genes of predisposition to breast cancer are known today?
– There are a dozen such genes, of which two are the main ones (BRCA1 and BRCA2), and the rest are less studied. We opened one of them.
– What percentage of morbidity do they determine?
– From 5% to 10%, that is, from every twentieth to every tenth case.
– And the rest are environmental factors?
– Unknown – I would say so. I would say that the role of the environment is exaggerated. The main reason is birth control, you can't get away from it.
– Do you mean contraceptives?
– No, not contraceptives, but just a low birth rate. The mammary gland is created for something else: it is designed by nature for lactation, feeding every year. Now it is impossible to live like this.
– Is it possible to assess the risk of morbidity, for example, if a woman has a mutation of one marker gene?
– Yes, as a rule, there is one mutation, and at the same time the risk reaches 90%. If it is a mutation in one of the most studied genes, BRCA1 and BRCA2, then 9 out of 10 women get sick.
– During life or in old age?
– Unfortunately, sometimes at a fairly young age – as a rule, from 30 to 60 years.
– Can this risk be adjusted by lifestyle?
– Only preventive surgery, when breast tissue is removed and silicone implants are placed.
– From the point of view of a specialist, is this operation justified?
- Yes. It is accepted abroad – if there is a mutation, preventive mastectomy is recommended.
– And in Russia?
– In Russia, we detect mutations, but it is not customary to do operations. The only case of a real preventive operation was in Krasnodar, where we found a mutation in a woman at 53, and she not only had the operation, but also showed it on television, on Channel One (journalist Masha Gessen, who publicly told about the mastectomy operation, did it in the USA. – "Newspaper.Ru»).
– And what is the reason that there are practically no such operations in Russia?
– Well, our doctors have a negative attitude to this, and patients do not want to go for it.
– And in the world?
– In the USA, Germany, France, 50% of women with a mutation agree to a mastectomy.
– Are the complications after the operation severe?
– No, if everything is done correctly, there are no complications. The most important thing is that the mammary gland loses sensitivity, which, of course, is significant from an erotic point of view. But that's it.
In general, summarizing, we can say that Angelina Jolie is right, and Russian society is too conservative. Indeed, Russians are unlikely to follow the path of the United States soon, where the appendix is already being prophylactically removed and circumcision is being done. Well, everyone has their own way.
Portal "Eternal youth" http://vechnayamolodost.ru15.05.2013