By Donald H. Harrison 

SAN DIEGO, Calif —A Hadassah Medical Center cancer specialist says women with a family history of breast cancer—on either their mother's or father's side—should consider genetic testing, adding that  this applies especially to women from Ashkenazic families.

Dr. Asher Y. Salmon told  a group that gathered around him following his lecture on Tuesday, Feb. 7, at UCSD Moores Cancer Center that there is a common misconception that the genetic mutations in the BRCA-1 and BRCA-2 genes that lead to breast cancer are only passed down the maternal line.  He warned that  if there was breast cancer on the paternal side—perhaps experienced by a paternal grandmother—it would be just as wise for a woman to undergo the testing.  The same is true for women with a history of ovarian cancer in their families, he said.


Dr. Asher Y. Salmon shares a moment before his lecture with Diane Sherman and Audrey 
Levine, co-chairs of Hadassah Southern California's "Chai Society Cocktail Evening."


Statistically, he said, women whose mothers had breast cancer are three times more likely than women in the general population to also develop the disease.  It is also known, Salmon said, that breast cancer is more common among white females than women of other races.  He said diet may be an important contributing factor to this racial disparity.

Salmon was the featured speaker at a "Chai Society Cocktail Evening"  sponsored by Hadassah Southern California at the Moores Cancer Center.  In his lecture, he  said that the incidence of BRCA-1 and BRCA-2 mutations are higher among Ashkenazic women then the women of the general population, with about 3 percent of Ashkenazic women being carriers of the mutation. Of these, he said, between 50 and 85 percent will develop breast cancer. 

Women with a genetic disposition for the disease have adopted different strategies in different countries, Salmon said.  In the Netherlands, about 70 percent of these women will undergo some form of preventive surgery, whereas in the United States the rate is 30 percent and in Israel, it is 20 percent.

Other strategies for women with the mutation are increased surveillance and experimental drugs, Salmon said.  

Besides treating  patients, Salmon said he has been engaging in basic research at Hadassah Medical Center that attempts to test the belief that so long as a woman carrying a BRCA mutation has another normal gene, she can resist cancer.  He said he is trying to determine whether it is true that the mutation takes over only after the "normal" gene is damaged.

There are numerous causes of breast cancer with the mutations in the BRCA genes being just one type.  Overall, he said one in nine women currently develops breast cancer.  Once it was believed that breast cancer posed the greatest threat to women between the ages of 53 and 58, but with increasing frequency over the last three decades, cancers have been appearing in women 10 years younger, he said.

Salmon said the Hadassah Medical Center in the Ein Kerem neighborhood of Jerusalem has been trying to develop new techniques for early detection of cancers in addition to the standard mammograms.  He said MRI's seem to be more successful with younger women.

Breast cancers can be cured through such techniques as surgery, chemotherapy, radiation, hormone therapy, and, in the future, there may be what he called "biological targeted therapies."

Salmon urged all women to regularly conduct self-examinations of their breasts, to have regular mammograms, and to follow balanced diets that are low in fat, high in Vitamin D.

Among attendees of Salmon's lecture were Dr. Ed Holmes, dean of UCSD's School of Medicine and UCSD's vice chancellor for health sciences, and Dennis Carson, director of the Moores Cancer Center.  The two men said there is a collaborative relationship among the center and such research organizations as the Salk Institute, the Burnham Institute and Scripps Research Institute.  They said benefits may be reaped from close cooperation among medical care providers and biotechnology and pharmaceutical companies.

"In Israel, they do not have a cancer center like this," Carson. said.  "People have to travel, and maybe someday Hebrew University (Hadassah) will have one."  Salmon acknowledged the strides made in San Diego, telling his audience of about 75 persons, "I have visited many cancer centers all over the world, and this is one of the most impressive ones."  He expressed the hope that if ever Israel is in a position to embark upon a similar venture, he would be able to return again and again to the Moores Cancer Center.