- Question from Northern CA: Can you comment about being diagnosed with the BRCA gene and the need to have the ovaries removed?
- Answer —Jennifer Griggs, M.D., M.P.H.: BRCA genes refer to genes that we inherit from our mother or father that increase our risk of getting breast cancer over our lifetime. At this point, there are 2 BRCA genes, called BRCA I and BRCA II. The genes are a little different in the risk they give in developing breast cancer. Women with BRCA I or BRCA II mutations are at higher risk of developing ovarian cancer as well. A woman should consider BRCA testing if she has been affected by breast cancer at an age of less than 40 years, or if she has multiple affected first degree family members or second degree family members, a family history of ovarian cancer, a family history of male breast cancer, or if she has had breast cancer and is of Ashkenazi Jewish descent. Breastcancer.org has a wealth of information about who should consider testing for the BRCA genes.
If a woman is found to have a BRCA gene, either BRCA I or BRCA II, and has had breast cancer, she may want to consider removal of the ovaries and fallopian tubes to reduce her risk of getting ovarian cancer or a cancer in the fallopian tubes, which can also happen. If she has had breast cancer and continues to have functioning ovaries, removing the ovaries may also reduce her risk by lowering estrogen, reduce her risk of getting breast cancer again.
For a woman who has a BRCA I or BRCA II mutation but has not had breast cancer, her major concern will be avoiding getting breast cancer or ovarian cancer; in other words, preventing these cancers. Knowing that she is at high risk of getting breast cancer, the patient and her doctors may consider breast surgery, that is removal of the breasts, and/or removal of the ovaries. In a premenopausal woman, removal of the ovaries will lower her estrogen levels and may lower her risk of getting breast cancer. In other words, by having her ovaries out, she may reduce her risk of both ovarian cancer and breast cancer. If she is postmenopausal, removing the ovaries will most likely not reduce her risk of breast cancer, but may reduce her risk of ovarian cancer.
In women who have BRCA I or BRCA II gene mutations, MRI of the breast is often offered as an additional form of screening (if she has never had breast cancer) or follow-up, if she has had breast cancer. Discussing these options with your physician is appropriate as soon as you find out you have one of these mutations, so that you can plan your future prevention strategies.
On Wednesday, December 19, 2007, our Ask-the-Expert Online Conference was called Updates from San Antonio 2007. Jennifer Griggs, M.D., M.P.H. answered your questions and shared the newest research presented at this year's San Antonio Breast Cancer Symposium.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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Jennifer Griggs, M.D., M.P.H. is a medical oncologist specializing in the treatment of breast cancer, with a a special interest in cancer survivorship, patient-physician communication, and quality of care for women with breast cancer.
