Alternatives to Prophylactic Ovary Removal

Removing the ovaries and fallopian tubes is the only proven strategy for significantly reducing ovarian cancer risk. For many premenopausal women, it also reduces breast cancer risk. However, there are alternatives you can consider.

• To reduce ovarian cancer risk: Some studies suggest that taking oral contraceptives (birth control pills) or having tubal ligation (a type of surgery that cuts or seals your fallopian tubes as a form of permanent birth control) can reduce ovarian cancer risk.
• To detect ovarian cancer early: Some women choose to be followed closely by their doctors to watch for signs of ovarian cancer. This can include having a CA125 blood test (a test to detect elevated proteins associated with ovarian cancer), manual pelvic exams, and transvaginal ultrasound every 6-12 months. Although these methods are not proven to detect ovarian cancer early, they give some women peace of mind.
• To reduce breast cancer risk:
  • Prophylactic mastectomy, or removal of the breasts, has the most dramatic impact on breast cancer risk.
  • Hormonal therapy medication, such as tamoxifen, can block the effects of estrogen on breast tissue and reduce the risk of breast cancer.
• To reduce the risk of breast cancer recurrence:
  • Temporary ovarian shutdown: Some women take medication that temporarily shuts down the ovaries’ production of estrogen. This is called temporary ovarian shutdown or suppression. Giving the body a “break” from high estrogen levels can reduce the risk of breast cancer recurrence in premenopausal women who have been diagnosed with estrogen-receptor-positive cancer.
    
    Medications that shut down the ovaries temporarily include Zoladex (chemical name: goserelin) and Lupron (chemical name: leuprolide). These are taken by injection, and they shut down the ovaries about 2-4 weeks after the first injection. Ovary shutdown can cause intense menopausal symptoms, as ovary removal does — but it is reversible. Once the medication is stopped, the ovaries start producing estrogen again. (In the past, low-dose radiation therapy was used to permanently stop estrogen production by the ovaries, but this practice generally is not used any more.)
  • Hormonal therapy medication: Medications such as tamoxifen and Arimidex can block or lower estrogen, reducing the risk of breast cancer recurrence.
• To detect breast cancer early: Frequent screening with clinical breast exams, mammograms, and magnetic resonance imaging (MRI) every 6-12 months may increase the chance of detecting breast cancer early.

For more about reducing the risk of breast and ovarian cancer, visit the Breastcancer.org Lower Your Risk section.