The findings of a large international prospective study published in the Journal of Clinical Oncology suggest for the first time that women with BRCA1 mutations should have preventive ovarian surgery (prophylactic oophorectomy) by age 35, as waiting until a later age appears to increase the risk of ovarian cancer before or at the time of the preventive surgery. Women with a BRCA2 mutation, however, do not appear to be at an increased risk by age 35, suggesting they may delay this procedure until later. Moreover, women with BRCA1 and BRCA2 mutations who had this surgery experienced a 77 percent reduction in their overall risk of death by age 70.
Prior studies have shown that prophylactic oophorectomy reduces the risk of developing breast and ovarian cancers in women with BRCA1 or BRCA2 mutations; this is the first study to show an overall mortality reduction benefit. As many as 70 percent of women in the United States who learn they have BRCA mutations choose to have prophylactic oophorectomy. Many doctors recommend that such women undergo surgery by age 35 or when childbearing is complete. However, neither the optimum age for having this preventive surgery nor the effect of the surgery on the overall risk of death had been adequately studied.
"To me, waiting to have oophorectomy until after 35 is too much of a chance to take," said Steven Narod, MD, professor of medicine at the University of Toronto in Canada and the study's lead author. "These data are so striking that we believe prophylactic oophorectomy by age 35 should become a universal standard for women with BRCA1 mutations."
He added: "Women with BRCA2 mutations, on the other hand, can safely delay surgery until their 40s, since their ovarian cancer risk is not as strong."
In the Hereditary Ovarian Cancer Clinical Study, researchers from Canada, the United States, Poland, Norway, Austria, France, and Italy identified women with BRCA mutations from an interna
|Contact: Kate Blackburn|
American Society of Clinical Oncology