Contralateral mastectomy for women with hereditary breast cancer

Angelina Jolie’s disclosure in May 2013 of her prophylactic bilateral mastectomy triggered a wide range of reactions among women, caregivers, and scientists. In an editorial in the New York Times the actress announced that she was a carrier of a BRCA1 genetic mutation, significantly increasing her risk of breast and ovarian cancer. Jolie’s decision was intended to lower her risk of developing and dying from breast cancer.

Carriers of a mutation in the BRCA1/2 gene who develop breast cancer face a decision similar to that of Jolie’s: should they part with their unaffected breast to prevent a second tumour? The question such women ask is: will this reduce my risk of dying from breast cancer? In a linked paper (doi:10.1136/bmj.g226), Metcalfe and colleagues present new data for consideration by affected women and their doctors. Results from this observational study suggest that preventive mastectomy of the contralateral breast may reduce the risk of dying from breast cancer by 48% within 20 years after the first diagnosis.

As the most common malignancy among women worldwide, breast cancer is a serious threat to women’s health. The prospect that …