Removing Ovaries May Help Save Lives

Oophorectomy reduced ovarian cancer risk in women with BRCA gene mutations

(RxWiki News) Many young women today don’t worry too much about how old they will be when they have children. But for women with the gene for breast cancer, waiting to decide might have dire consequences.

Women who carry the BRCA1 or BRCA2 mutation that puts them at an increased risk for breast cancer live with the knowledge that they are more likely to develop breast or ovarian cancer as they age than women without these genes.

A recent study found that women with these gene mutations who underwent surgery to remove their ovaries (known as an oophorectomy) were much less likely to develop cancer of the ovaries, fallopian tube or peritoneum than women who did not have the surgery.

The women who had their ovaries removed were also much more likely to live into their 70s.

"If you have the breast cancer gene, discuss cancer prevention with your doctor."

Researchers, led by Dr. Steven A. Narod of the University of Toronto, enrolled 5,783 women with breast cancer gene mutations, known as BRCA1 or BRCA2, in their study. These women were identified from an international registry which included women from North America, Austria, France, Italy, Norway and Poland who had completed a baseline questionnaire and at least one follow-up questionnaire.

After an average follow-up of 5.6 years, 186 women developed either ovarian, fallopian or peritoneal cancer. Of these, 108 were diagnosed before they had an oophorectomy, 46 had a cancer that was discovered after the surgery, and 32 had a peritoneal cancer after oophorectomy.

Those women with the breast cancer genes who had undergone oophorectomies had an 80 percent reduced risk for the above-mentioned cancers, and a 77 percent lower rate of death, than women who had not undergone the procedure.

Having an oophorectomy reduced the risk for breast cancer by 48 percent in women with the BRCA1 mutation.

The cancer risk was significantly reduced if the woman was under age 35 when she had the oophorectomy, although having the surgery at an older age also reduced the risk to some degree, the researchers noted.

According to these researchers, a woman's age and whether or not she already has children are other factors that should be considered when deciding whether to undergo oophorectomy.

Women should be aware that oophorectomy comes with its own risks. Women who have the procedure have less ciruculating estrogen, which increases their risk of developing bone thinning, known as osteoporosis. These women are more likely to have early menopause and to develop high cholesterol and heart disease. Finally, while the risk for breast and ovarian cancer is very much reduced with the procedure, women who undergo oophorectomy can still develop these cancers.

In previous studies, the researchers have found that women carrying the BRCA1 or BRCA2 gene were very accepting of having preventive oophorectomy to reduce their risk for cancer and possibly death.

Women who carry either of the breast cancer genes face a higher risk for cancer or death without oophorectomy. Dr. Narod and colleagues found that the risk was significantly higher for those with the BRCA1 gene mutation.

This study appeared in the February 24 issue of the Journal of Clinical Oncology.

Dr. Narod and colleagues disclosed no potential conflicts of interest in their study.

Review Date: 
February 26, 2014