© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Surgery to remove the ovaries and fallopian tubes in women with mutations (changes) in certain breast cancer genes (BRCA1 and BRCA2) reduces the risk of developing breast and ovarian cancers, according to a long-term study. This reduction in risk varies according to the type of mutation. For example, women with mutations in the BRCA1 gene have a larger decrease in ovarian cancer risk following the surgery, while those with BRCA2 mutations have a larger decrease in breast cancer risk.
"This study provides the strongest confirmation to date that risk-reducing removal of the ovaries and fallopian tubes prevents both breast and ovarian cancers in women with mutations in BRCA1 and BRCA2," said Noah Kauff, MD, Assistant Attending Physician at Memorial Sloan-Kettering Cancer Center in New York City and lead author of the study. "It is also the first study to suggest that removal of the ovaries may have different effects on BRCA1 and BRCA2 mutation carriers."
In this study, researchers compared the number of new cases of breast and ovarian cancers between 561 women with a BRCA1 or BRCA2 mutation who had surgery to remove their ovaries and fallopian tubes, and 325 women with these mutations who did not have the surgery. All of the women in the study were age 30 or older; they were enrolled in the study beginning in November 1994 and followed through November 2005.
After 40 months of follow-up, the breast cancer risk was lowered by 47% and the ovarian cancer risk by 89% in women who had the surgery. Further analysis showed that the surgery reduced breast cancer risk in women with a BRCA2 mutation by 72%, compared with 39% among those with a BRCA1 mutation. The surgery reduced ovarian cancer risk in women with a BRCA1 mutation by 87%. No ovarian cancers were found after surgery in women with BRCA2 mutations; however, ovarian cancer was found in two women who did not have surgery.
What This Means For Patients
Women with BRCA1 or BRCA2 mutations are encouraged to talk with their doctors about the risks and benefits of risk-reducing surgery to remove their ovaries and fallopian tubes. Although the benefits of this surgery have been previously studied, the results of this study provide additional information that the type of mutation relates to differences in risk reduction. Knowing this information may help women with BRCA mutations make decisions about their health.