In a study using a computer model and published information on breast cancer and costs of current strategies to prevent breast cancer, researchers calculated the harms, benefits and costs of six interventions for women who do not have breast cancer but carry a single BRCA1 or BRCA2 gene mutation.

The study was published in the journal Annals of Internal Medicine.

The interventions or strategies considered were oral contraceptives, which appear to reduce risk for ovarian cancer; the drug tamoxifen, which appears to reduce risk for breast cancer; surgical removal of both ovaries; surgical removal of both breasts; surgical removal of breasts and ovaries; or no preventive measures (surveillance or watchful waiting).

The decision model found that for women with the BRCA2 gene mutation, combined preventive surgical removal of the ovaries (oophorectomy) and breasts (mastectomy) was cost-effective compared to removal of the ovaries alone. Either of these treatments was less costly and more effective than mastectomy alone, tamoxifen, or surveillance. For BRCA1 carriers, oophorectomy was the most cost-effective of all strategies.

SOURCES:
Annals of Internal Medicine, March 21, 2006
American College of Physicians (http://acponline.org)