'Tube-Tying' Procedure Reduces Risk of Ovarian Cancer
"Only 18% of the women with ovarian cancer had tubal ligations compared to 35% of the healthy controls," he says. Narod says tubal ligation cuts ovarian cancer risk by 60%. The risk reduction is even greater -- 72% -- if the women used birth control pills, he says. He did not find a similar association among women with BRCA2 mutations but says that only one in four women had BRCA2 mutations so the "sample size was so small that it would be difficult to detect a benefit."
David Mutch, MD, a professor at Washington University School of Medicine, tells WebMD that other studies have demonstrated that "all women who have tubal ligations have a decreased risk for ovarian cancer regardless of genetic background, so it doesn't surprise me that women with BRCA1 [mutations] could significantly reduce their ovarian cancer risk with surgery."
But Mutch says that surgery itself is a risk so "why do two surgeries with two anesthesias? I think if the woman is done having children she can just have an oophorectomy."
Narod says that he thinks women are willing to have a tubal ligation at a younger age than oophorectomy. "They can have a tubal [ligation] as soon as they are done having children," he says. In his own practice he recommends that women who carry the BRCA1 or BRCA2 mutations "begin taking oral contraceptives in their late teens and continue for at least five years. They can then have a tubal ligation when they are finished having babies and follow that with oophorectomy at age 35."
Whatever surgery a woman chooses, Mutch says that before the procedure, the woman should first undergo extensive genetic counseling. The genetic counselor will help the woman accurately construct a family tree. Mutch says that many times women have erroneous information about their families' medical histories. "The genetic counselor will send out for medical records and pathology reports to confirm the woman's memory," he says.
After the counseling, the woman and the counselor can decide if genetic testing is indicated. At that point, the woman should have enough information to make an informed judgment when she meets with her physician, Mutch says.