BRCA-carriers have an ovarian cancer risk high enough to warrant oophorectomy

OocyteA new study published in the Journal of Clinical Oncology quantifies the degree to which a BRCA mutation increases the risk of ovarian cancer, and it turns out to be frighteningly high. An international group of researchers led by Dr. Steven Narod from the Women s College Research Institute and the University of Toronto, Canada, tracked almost 6,000 women with one of the BRCA mutations for an average duration of 5.6 years (some for as long as 19 years).

Among the 5,783 patients, 2,123 had surgery when they enrolled and another 1,390 reported having surgery in follow-up questionnaires. The other 2,270 didn't have the procedure. All told, 186 developed ovarian or related cancers and 68 died.

However, those who had prophylactic oophorectomy (surgical removal of the ovaries) by age 35 reduced their risk of cancers of those organs by 80 percent, and their risk of dying of any cause by age 70 was reduced by 77 percent.

In the U.S., there are 232,000 new cases of breast cancer diagnosed among women each year and about 40,000 deaths, and 22,000 new cases of ovarian cancer and 14,000 deaths. Mutations in BRCA1 and BRCA2 genes generally run in families and account for about 5% to 10% of breast cancers and 15% of ovarian cancers. The risk of ovarian cancer among all BRCA-carriers is in the 40-55 percent range, lifetime.

ACSH s Dr. Gil Ross had this comment: This is the first such quantitative analysis of the actual risk of ovarian cancer in BRCA carriers, and certainly the first to tackle the complex issue of reducing that substantial risk with surgery. While the loss of ovarian function at a young age is fraught with complications and concerns, both hormonal and reproductive, to me it does not seem worth contemplating when the risk of such highly-lethal cancers is considered. Of course, modern egg-saving techniques are available to preserve reproductive capabilities in those women still wanting to have children (or more children), and hormonal therapies usually deal quite well with the induced menopause that follows this surgery.