Removing ovaries may not reduce breast cancer risk in women with BRCA1 mutations Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Tuesday, September 27, 2016

Removing ovaries may not reduce breast cancer risk in women with BRCA1 mutations



Women's College Hospital (newsletter) 
 
Removal of the ovaries may not reduce the risk of breast cancer for women with BRCA1 mutations, researchers at Women’s College Hospital (WCH) found.
Women with BRCA1 and BRCA2 gene mutations are at high risk for both breast cancer and ovarian cancer. Removing the ovaries and fallopian tubes prevents ovarian cancer, but it has been unclear whether it also helps prevent breast cancer in women with BRCA mutations. Some earlier studies have suggested a significant risk reduction, while more recent research has found no benefit for breast cancer.
A new study led by Joanne Kotsopoulos, PhD, a scientist at the Women’s College Research Institute, compared breast cancer incidence in women with BRCA mutations based on whether or not they had had undergone oophorectomy (removal of the ovaries). The results suggest that the surgery may reduce breast cancer risk before age 50 for women with BRCA2 mutations, but not for women with BRCA1 mutations.
The prospective study included 3,722 women with BRCA mutations: 1,552 women who had undergone oophorectomy, and 2,170 who still had their ovaries. About 80 per cent of the study subjects had BRCA1 mutations, and about 20 per cent had BRCA2 mutations. The research team, including the study’s senior author Dr. Steven Narod, director of the familial cancer research group at WCH, followed the women for an average of 5.6 years, during which time 350 of them developed breast cancer.
Overall, there was no reduction in breast cancer risk associated with oophorectomy for women with BRCA mutations. However, when the results were analyzed by sub-groups, there was a protective effect against breast cancer before age 50 in women with BRCA2 mutations. The authors caution that this finding needs confirmation, given the very small number of women in one of the sub-groups.
Removal of the ovaries and fallopian tubes is still recommended for women with BRCA1 (at age 35) and BRCA2 (at age 40) mutations to protect against ovarian cancer.
The study (abstract) was published online in the Journal of the National Cancer Institute on Sept. 6, 2016.

 Conclusions: Findings from this large prospective study support a role of oophorectomy for the prevention of premenopausal breast cancer in BRCA2, but not BRCA1 mutation carriers. These findings warrant further evaluation.

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