for those weighing the risk of "stirring up their breast cancer" by having surgery

[Lani]

after taking part in a recent thread on whether to have a prophylactic mastectomy on the uninvolved breast without being a BRCA1/2 carrier, I brought up the risk of activating inflammatory cascades.

In a just released article on why african americans mortality from breast cancer is higher than european americans they postulated it was because AA bc was more often premenopausal and cited articles showing that the risk of activating dormant distal metastases is greater in premenopausal women

I cite the following from the press coverage of that article:

It has also been shown, in a study of 1173 women in Italy undergoing breast cancer surgery, that surgery to remove a primary tumor induces angiogenesis of distant dormant micrometastases in 20% of node-positive patients who are premenopausal.

Surgery-induced angiogenesis is recorded in five times as many node-positive patients than node-negative patients, and in twice as many premenopausal patients than postmenopausal patients.

This, the researchers say in the International Journal of Surgery, may help to explain the "mammography paradox" – that mammography screening has significantly less benefit in women aged 40–49 years than in those aged 50–59 years.

It might also tie-in with the belief in 69% of the AA community, versus 29% of EA communities, that "exposing a cancer to air" will cause it to spread. This has been dismissed as superstition, but may simply be due to the observation that AA women appear twice as likely to die after cancer treatment as EA women.

The team goes on to say that early detection of breast cancer with mammography began in the 1970s. Consequently, seeing as AA breast cancer is largely premenopausal and EA breast cancer is largely postmenopausal, it logically follows that, due to surgery-induced early mortality, outcomes from the 1970s would be improved in EA patients compared with their AA counterparts.

"In conclusion, we suggest that the observed race-related changes in breast cancer mortality may, in part, stem from screening and subsequent resection of poor-prognosis breast cancers among AA premenopausal women, which negatively impacts the host–cancer balance in a subset of these women."



Int J Surg 2007; Advance online publication

I hope this helps somewhat those with difficult decisions to make!