Pre-Emptive Surgery Lessens Risk of Ovarian or Breast Cancer

Women who have gene mutations that put them at high risk of ovarian and breast cancer can significantly reduce the risk of developing or dying from these cancers by having their healthy ovaries or breasts removed, according to a new study reported in the Sept. 1 issue of the Journal of the American Medical Association.

Twenty-two clinical and research genetics centers in Europe and North America were involved in the study of 2,482 women with inherited BRCA1 or BRCA2 gene mutations between 1974 and 2009.

“These findings should help women with these mutations and their doctors select strategies to reduce a patient’s chances of developing breast and gynecological cancers,” Henry Lynch, MD, director of the Hereditary Cancer Center, holder of the Charles F. and Mary C. Heider Endowed Chair in Cancer Research at Creighton and one of the study’s co-authors, stated in a press release. “The bottom line is that lives can be saved. Clearly, these are compelling results, demonstrating that preventive surgery offers a significant level of protection against breast and ovarian cancer for women carrying the BRCA1 and BRCA2 gene mutations.”

The study followed each of the women for about 4 years. During the study, women who had their ovaries and fallopian tubes removed reduced their risk of dying from ovarian cancer by 79% and from breast cancer by 56%.

Lynch noted that many women who test positive for BRCA1 or BRCA2 mutations, particularly young women, are reluctant to have the preventive surgeries to reduce their risk of breast or ovarian cancer because of how it will affect their physical appearance or because they plan to have children.

These women need to be intensively monitored by their physicians and receive more frequent screenings, including mammograms. Preventive chemotherapy is another option, Lynch stated.

Women who have inherited mutations in the BRAC1 or BRCA2 genes have substantially elevated risks of breast cancer and ovarian cancer, with a lifetime risk of breast cancer of 56% to 84%. The estimated ovarian cancer risks range between 36% to 63% for BRCA1 mutation carriers and 10% to 27% for BRCA2 carriers.

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