Breast Cancer Risk And Ovary Removal

Women at high risk of developing breast cancer because of a genetic mutation can reduce the risk as much as 67 percent by having their ovaries removed, a new study finds.

The study focused on women at five institutions who had tested positive for a mutation of the BRCA1 gene, a condition linked to a high risk of breast cancer, said Timothy R. Rebbeck of the University of Pennsylvania School of Medicine.

Forty-seven of the women studied had undergone surgery to remove both ovaries, while another 79 women had the gene mutation but not the surgery. Among those who had ovarian surgery, there was a 67 percent reduction in the incidence of breast cancer after 10 years, Rebbeck and colleagues report in today's issue of the Journal of the National Cancer Institute. For women followed for between five and 10 years, the risk reduction was about 72 percent.

The BRCA1 gene mutation is thought to be a factor in a small percentage of both breast and ovarian cancer cases nationally, but among women with the mutation the chances of developing the diseases are very high, Rebbeck said.

For women with the mutation plus a family history of breast cancer, the lifetime risk of breast cancer can be as high as 80 percent, he said. For ovarian cancer, the risk can be 40 percent to 50 percent, Rebbeck said.

Rebbeck said the study does not suggest that ovarian removal is the solution for all women with the BRCA1 mutation, or even that all women should be checked for it.

Training Doctors On Smoking Cessation

U.S. medical school graduates are woefully unprepared to help patients quit smoking, a new study concludes.

Researchers surveyed nearly every accredited medical school in the country and found very little course work devoted to nicotine dependence, according to a report in today's Journal of the American Medical Association.

The researchers looked at responses from 122 of 126 medical schools about course offerings in the 1996-97 school year. Thirty-two out of 102 schools dedicated an average of less than one hour of classroom time per year on smoking cessation techniques.

Only three schools reported having a required course devoted to tobacco education in the third and fourth years. And almost 70 percent of schools--83 of 120--did not require any smoking cessation training at all in those two years, when students are learning how to apply their knowledge to patients.