How do you know if you are at high risk for ovarian cancer?
You can't begin to decide whether to have surgery until
you have an estimate of how high your risk is. If you don't know whether you
are at high risk, talk to your doctor. A genetic counselor can also help
Your risk depends on your medical history and your family
history. For example, having one relative with ovarian cancer means you are
more likely than average to get it. But if you have more than one relative with
this cancer, your chances of getting it are much higher, and you may want to
talk to a genetic counselor. See
who is at high risk for ovarian cancer.
To understand how a
family history of ovarian cancer can affect your chances of getting it, look at
the numbers below. It’s important to remember that everyone’s case is
different, and these numbers may not show what will happen in your case.
- Out of 100 average women, 1 or 2 will get
- That risk goes up to 4 or 5 out of 100 for women
with one family member who has had ovarian cancer. The risk is 7 out of 100 for
women with two relatives who have had it. And if at least two first-degree
relatives (meaning mother, sister, or daughter) have had ovarian cancer, the
risk is 25 to 50 out of 100.4
- The risk
also goes up for women who inherit a BRCA gene change. Out of 100 women who
inherit the BRCA1 gene change, 20 to 60 will get ovarian cancer. Out of 100
women who inherit the BRCA2 gene change, 10 to 35 will get ovarian
- Should I have a BRCA gene test?
What are the benefits of having your ovaries removed?
Studies show that surgery may lower your chances of getting ovarian
cancer by 85% to 95%.
This means that it may lower your risk of ovarian cancer
so that you have the same or only slightly higher risk than the average woman.
The numbers below may help you understand.
Having your ovaries removed can lower your risk for ovarian cancer
Chances of getting ovarian cancer (without surgery)
Chances of getting ovarian cancer after surgery
1 or 2 out of 100
(There is no reason for the
average woman to have this surgery.)
Woman with a strong family history
Up to 50 out of 1004
2 to 7 out of 100
Woman with a BRCA gene change
Up to 60 out of 1005
3 to 9 out of 100
What are the risks of having your ovaries removed?
- When your ovaries are removed, you can no
longer have children.
- Without your ovaries, you will go into early
menopause. Menopause often has symptoms like hot
flashes and vaginal dryness. It also raises your risk for heart disease and
osteoporosis. Although many women
in menopause take
hormone therapy to keep from having symptoms like hot
flashes, hormone therapy is not recommended if you are trying to prevent
ovarian and breast cancer.
- Removing the ovaries does not always
prevent cancer. Sometimes a woman already has cancer before the operation but
doesn't know it because she has no symptoms. And the cancer cells may already
have begun to spread outside the ovaries. In that case, removing the ovaries
will not remove all of the cancer cells. Cancer can also start in the abdominal
cavity after the ovaries are removed, but this is rare.
- A recent
study estimated that women who have their ovaries removed before age 45 live
longer when they take estrogen replacement.
- One recent study
showed that women younger than 45 who have their ovaries removed and who do not
take replacement therapy are more likely than other women to die of heart
disease, mental disorders, or diseases of the nervous system.6
What other choices do I have?
Being at higher risk
for ovarian cancer does not mean you will definitely get ovarian cancer. For
this reason, some women choose not to have surgery. If you decide not to have
surgery, you can consider two other options:
- Birth control pills. Studies have found that
taking birth control pills for more than 5 years lowers the average woman's
chances of getting ovarian cancer. The results are not clear on the use of
birth control pills in women who have BRCA gene changes.
checkups and testing. The goal here would be to find any cancer as early as
possible, when the chances of treating it successfully are higher.
There is no evidence that having regular tests helps
women live longer by finding ovarian cancer early. Still, experts recommend
that women who have inherited a BRCA gene change and have not had their ovaries
removed have the following tests at least once a year, starting at age
- Transvaginal ultrasound.
Ultrasound uses sound waves to make a picture of your
organs and other body parts. A small handheld device called a transducer is
passed back and forth over the area in question. In a transvaginal ultrasound,
the transducer fits into a woman's vagina. The test is used to look for tumors
in and around the ovaries.
- CA-125 blood test. CA-125 is a
protein. A higher-than-normal amount of this protein
can mean that cancer is present. The test is usually used to check how well
treatment for ovarian cancer is working or to see if ovarian cancer has
Women who have inherited a BRCA1 gene change (not a BRCA2
gene change) may want to start having these regular tests as early as age
If you need more information, see the topic