Women with disease-related BRCA1 and BRCA2 variants many be able to reduce their risk of ovarian cancer or death by undergoing preventive removal of their ovaries, according to a study published this week in the Journal of Clinical Oncology.
Actress Angelina Jolie announced last spring that she underwent a preventive double mastectomy after learning her BRCA1 carrier status and high risk of developing breast and ovarian cancer. In her New York Times op-ed, Jolie said that her doctors put her risk of breast cancer at 87 percent and ovarian cancer at 50 percent before her surgery. Jolie's mother, Marcheline Bertrand, died of ovarian cancer.
In this new study, researchers led by Steven Narod from the University of Toronto followed nearly 6,000 women with BRCA1 or BRCA2 mutations predisposing them to cancer for an average 5.6 years, collecting data regarding cancer diagnosis, treatment, death, and more. From this, they estimated that preventive oophorectomy could reduce the risk of ovarian, fallopian tube, or peritoneal cancers by about 80 percent in BRCA1 or BRCA2 carriers and reduce mortality by 77 percent.
Narod and his colleagues add that their findings support the recommendation that women with BRCA1 mutations have an oophorectomy at age 35 years to limit their chance of disease.
"To me, waiting to have oophorectomy until after 35 is too much of a chance to take," Narod, the study's lead author, says in a statement. "These data are so striking that we believe prophylactic oophorectomy by age 35 should become a universal standard for women with BRCA1 mutations."
The researchers note that in their cohort of BRCA2 carriers, one patient developed ovarian cancer before the age of 50, suggesting that BRCA2 carriers may be able to delay oophorectomy.
The University of Southern California's Agustin Garcia tells CNN that this distinction between carriers is important, as many guidelines don't differentiate between BRCA1 and BRCA2 carriers.
"These results could make a real difference for women with BRCA mutations, who face tough decisions about whether and when to undergo a prophylactic oophorectomy," adds Don Dizon, from American Society of Clinical Oncology, in a statement.