Removing Breasts, Ovaries Cuts Cancer Risk in Women at High Risk

Some women have gene mutations, known as BRCA-1 and BRCA-2, which increase their risk of developing breast and ovarian cancer. Here are the stats:

- 56 to 84% of women with BRCA-1 or BRCA-2 mutations will develop breast cancer
- 36 to 63% of women with BRCA-1 will develop ovarian cancer
- 10 to 27% of women with BRCA-2 will develop ovarian cancer

If you think your odds of having one of these mutations might be high, you can get genetic testing to find out. This process involves giving a blood sample and also usually genetic counseling beforehand, during which time you will be asked about your family history and health to determine what kind of genetic testing to do.

Women who have BRCA-1 or BRCA-2 mutations have a few options: body-altering surgery, preventive chemotherapy or more intense screenings for breast and/or ovarian cancer.

Going the surgery route is a heavy psychological decision, as it impacts one's appearance (in the case of breast cancer) or ability to have children (in the case of ovarian cancer). If a woman with greater ovarian cancer risk is done having children, a doctor will often suggest surgery. For women at greater ovarian cancer risk who still want to have children, it may be possible to only remove one ovary/fallopian tube. This depends how advanced the cancer is, but still, the Mayo Clinic notes that the chemotherapy afterward can cause infertility.

A new study, reported on by Health.com, illustrated that women with the BRCA-1 or BRCA-2 mutations who have their breasts or ovaries preemptively removed can significantly reduce their odds of getting these forms of cancer. The study, which appeared in the Journal of the American Medical Association, followed almost 2500 women with the BRCA gene for about four years.

Among the women in the study who were at risk of breast cancer, none who got a preemptive mastectomy developed breast cancer (during the time of the study).
Seven percent of the women who didn't get a preemptive mastectomy, but who instead were on an intensive screening schedule, developed breast cancer.

And among the women in the study who were at risk of ovarian cancer, only one percent of those who underwent surgery to remove at least one ovary and fallopian tube (called a salpingo-oophorectomy) developed ovarian cancer. Six percent of those who did not undergo the surgery developed ovarian cancer.

Though it's clear preemptive surgery can cut the cancer risk of women with certain genetic mutations, there's still a lot of reluctance to pursue the procedure. Only 10 percent of women with the BRCA gene mutation in the study had a preventive mastectomy, while 38 percent removed one or both ovaries and fallopian tubes.

We know the whole topic of breast and ovarian cancer is heavy, scary stuff, but staying informed is always a healthy approach.