Cancer gene carriers cut risk with ovarian surgery
Women who carry a gene mutation that increases their risk of breast cancer appear to be able to lower their risk of breast and gynecologic cancers by undergoing the removal of their ovaries, results of a 10-year follow-up study show.
Dr. Fatima Laki and colleagues at the Institut Curie in Paris analyzed the survival rates of 89 women with BRCA1 and/or BRCA2 mutations who has their ovaries removed, a procedure also referred to as salpingo-oophorectomy, between 1994 and 2004 at their institution.
The women were an average of 51 years old when they underwent salpingo-oophorectomy.
A family history of breast or ovarian cancer was determined in 88 of the 89 women and 73 had a personal history of breast cancer.
There were 4 deaths among the 89 women in the study. Three died from breast cancer and 1 from pancreatic cancer.
Previously undetected ovarian and fallopian tube cancers were found in 4 women at the time of surgery. Before surgery, these women had normal ultrasound scans and levels of the tumor marker CA125.
Two of the 4 women remain disease-free. One had a recurrence after 4 years. One died of breast cancer 12 months after salpingo-oophorectomy.
Breast cancer developed in 3 of the 16 women without a personal history of the disease. Of the women with a previous history of breast cancer, 14 had a recurrence in the same or opposite breast and 8 had their cancer spread to other organs.
The results of the 10-year study are published in the medical journal Cancer.
The Institut Curie team concludes a larger study with a longer follow-up is needed “to more precisely evaluate the benefits of this procedure.”
Other studies have shown that prophylactic salpingo-oophorectomy lowers the risk of a first breast cancer or breast cancer recurrence by 50 percent and has the greatest benefit among women younger than 40 years of age.
“This study shows that prophylactic salpingo-oophorectomy remains an important option for women at risk of hereditary breast or gynecologic cancer,” Laki’s group continues.
They add, however, that women need to know their BRA1/2 mutation status to increase the rate of salpingo-oophorectomy BRCA1/2 mutation carriers who have not yet developed breast or ovarian cancer.
SOURCE: Cancer, May 1, 2007.
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