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Ovarian Cancer Gene and Early Removal of Ovaries

In particular, women with BRCA1 mutation should have surgery by age 35, researchers say

WebMD News from HealthDay

U.S. study finds those living in regions with

By Steven Reinberg

HealthDay Reporter

MONDAY, Feb. 24, 2014 (HealthDay News) -- Women who carry a BRCA1 gene mutation and have their ovaries removed by age 35 appear to dramatically reduce their odds of developing ovarian cancer and dying, a new international study finds.

Having this procedure, called oophorectomy, may reduce the odds of dying by age 70 by about 77 percent, researchers say. Women who have BRCA1 or BRCA2 gene mutations are at greater risk of developing breast and/or ovarian cancer.

"We have a strong basis to recommend that women who have a BRCA1 mutation really benefit from having an oophorectomy, and they should have it by age 35," said lead researcher Dr. Steven Narod, a professor of medicine at the University of Toronto, in Canada.

Women with BRCA2 mutations can delay surgery until they're 40, since their risk of ovarian cancer is not as strong, he added.

The procedure made news last year when film star Angelina Jolie, a carrier of the BRCA1 mutation, announced plans to have her ovaries removed. Previously, she had undergone a preventive double mastectomy. Jolie's mother, actress Marcheline Bertrand, died of ovarian cancer at the age of 56.

Study author Narod noted that the benefits of the surgery outweigh the side effects. Those side effects include menopause symptoms, such as hot flashes and sleep disturbances, which can be managed by hormone replacement therapy, he said.

Other side effects may include a small increase in the risk for heart disease and possibly memory and thinking problems. Of course, removing the ovaries means not having children, but by 35 the women could have already started a family, Narod said.

The real challenge, Narod added, is getting women screened for BRCA mutations. Most women who have these mutations don't know they have them. "Probably only one in 300 women carry these mutations," he said.

"If we are going to get the full impact, it's important that more women get tested," Narod said. But making genetic testing more available means lowering the cost from around $1,000 to $100, he added.

Narod's team is currently running pilot programs in Iceland and Bermuda testing every woman who has a mammogram for BRCA mutations as well.

Ovarian cancer is often called the "silent killer" because symptoms may not appear until the cancer had spread. In 2013, the U.S. National Cancer Institute estimated that 22,240 women would be diagnosed with the disease that year and 14,030 would die from it.

This is why in the United States, as many as 70 percent of women who know they carry BRCA mutations choose to have their ovaries removed, the researchers noted.

The report was published Feb. 24 in the Journal of Clinical Oncology.

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