Wednesday, February 26, 2014

Why More Women May Start Removing Their Ovaries

Why More Women May Start Removing Their Ovaries

A new study suggests that women with the BRCA1 mutation should undergo the surgery by age 35

You’ve probably heard that having a mutation of the BRCA1 gene puts you at an increased risk of breast and ovarian cancer (it ups your odds to 80 percent and 40 percent, respectively, on average). It’s the same genetic mutation that Angelina Jolie tested positive for, inspiring her to get a preventive double mastectomy. But new research suggests that a mastectomy isn’t the only preventive surgery women might want to consider if they have the faulty gene. In fact, women with BRCA1 and BRCA2 mutations who had their ovaries removed reduced their risk of ovarian cancer by 80 percent and reduced their overall risk of death by 77 percent, according to a new study in the Journal of Clinical Oncology

MORE: What Angelina Jolie DIDN’T Teach Us About Breast Cancer

The researchers observed 5,783 women with a BRCA1 or BRCA2 mutation for an average of 5.6 years. Just over 2,100 women had already had their ovaries removed at the start of the study, and another 1,390 women underwent the surgery (called an oophorectomy) during the study period. Not only did these women have a significantly lower risk of ovarian cancer and death, but they also saw a reduced risk of breast cancer. “If you’ve had breast cancer in the past—even five or 10 years ago—having the oophorectomy is a good way of extending your life expectancy,” says study co-author Steven Narod, M.D., of the Women’s College Research Institute in Toronto, Canada. “It reduces the likelihood of breast cancer coming b ack.” While they’re not sure exactly why, researchers think it may have to do with the hormones produced by the ovaries, including estrogen and testosterone.

Based on these results, the researchers suggest that all women with the BRCA1 mutation have their ovaries removed by age 35. Since the risk of ovarian cancer is lower in women with a BRCA2 mutation, researchers suggest these women have their ovaries removed by age 40.

MORE: Study: How Genetic Testing Affects Your Breast Cancer Risk

Even with this research-backed suggestion, the decision to remove your ovaries is one that many women would have to carefully consider. The surgery induces early menopause, which brings along a host of symptoms like hot flashes, sleep disturbances, hormonal imbalances, and psychological effects, says Narod. This also means that women won’t be able to have children after the surgery, which could make it a particularly tough decision for women who plan to have children at a later age. Also of concern are the long-term effects of this surgery, which haven’t been well established yet. “In the long term, we’re concerned about heart disease, bone density, and memory loss,” says Narod. “These women are still young, so we have a grant and are looking at the long-term effects.” But for many, the peace of mind that comes with lowering your cancer risk is re ason enough to have the surgery.

If you have a known genetic mutation that puts you at an increased risk for breast cancer or ovarian cancer, Narod suggests speaking with a genetic counselor and a physician to see if the surgery is right for you. And if you aren’t sure about your genes, find out more about how genetics affect your breast cancer risk.

MORE: About That Study That Says Mammograms Don’t Save Lives…What You Need to Know

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