Friday 24 April 2015

Ovary Removal Reduces Breast Cancer Death in BRCA1 Carriers: Study

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The sooner, the better, researchers found


WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, April 23, 2015 (HealthDay News) -- Actress and activist Angelina Jolie made news last month when she announced she had her ovaries removed -- after undergoing a preventive double mastectomy in 2013 -- because she is a carrier of BRCA, a genetic mutation that greatly increases the risk of breast and ovarian cancers.

Jolie did not have cancer but underwent both surgeries to reduce her cancer risk. Now, a new study supports preventive ovary removal in women with breast cancer who also carry the BRCA1 mutation. Women can greatly reduce their risk of dying from the breast cancer if they undergo ovary removal ("oophorectomy") -- and the sooner the better, the researchers said.

"By having an oophorectomy done soon after a breast cancer diagnosis, we can increase the chance a woman with a BRCA1 mutation will survive her breast cancer," said study researcher Kelly Metcalfe, professor of medicine and nursing at the Women's College Research Institute of the University of Toronto.

How soon is best? "We're suggesting within the first year," Metcalfe said.

When women find out they are BRCA carriers, Metcalfe said, they are usually advised that their risk of breast and ovarian cancer rises sharply. They are also counseled about preventive mastectomy and oophorectomy. The new study points out the importance of having that surgery as soon as possible, Metcalfe said.

However, the decision is a difficult one. Any surgery carries risks, and ovary removal before menopause causes early menopause.

"Some choose not to remove their ovaries until they are done with childbearing," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

While the researchers found a link between ovary removal in women with BRCA1 and lower risk of death from breast cancer, they can't prove cause and effect. However, Metcalfe said, the investigators accounted for many factors, such as type of tumor and treatment plan to tease out the effect of the surgery.

For the study, published online April 23 in JAMA Oncology, the researchers followed 676 women who had early stage breast cancers and were carriers of BRCA1 or BRCA2 mutations.



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