Young women with BRCA1 mutation 'should remove ovaries earlier'

It is widely known that having a BRCA1 gene mutation increases risk of female breast and ovarian cancers. And now, findings from a large international study suggest that women with these mutations should have preventive surgery to remove the ovaries by the age of 35, rather than waiting until a later age when the risk of ovarian cancer greatly increases.

According to the National Cancer Institute, about 1.4% of women in the general population will develop ovarian cancer at some point in their lives. However, for women who inherit a BRCA1 mutation, 39% will develop ovarian cancer.

Because of these risks, researchers - led by Amy Finch and Dr. Steven Narod of Women's College Hospital in Canada - wanted to estimate the reduction in risk of death due to ovarian, fallopian tube or peritoneal cancer in women with a BRCA1 or BRCA2 mutation after oophorectomy (removal of the ovaries).

They published the results of their study in the Journal of Clinical Oncology.

The team notes that as many as 70% of women in the US who are aware they have BRCA mutations opt for removal of the ovaries, and many doctors suggest these women have the surgery by age 35 or when they no longer wish to bear children.

But until now, the best age for having the surgery - or its effects on overall mortality risk - had not been studied.

Finch, a researcher at Women's College Research Institute, says:

"Scientific evidence clearly shows removal of a woman's ovaries and fallopian tubes is very effective in preventing both breast and ovarian cancer in women with a BRCA mutation. But the real question has been at what age these women should have the surgery to best diminish their chance of developing cancer."

To find out, researchers from Canada, the US, Poland, Norway, Austria, France and Italy pinpointed women in an international registry who had BRCA mutations. In total, 5,787 completed questionnaires about reproductive and surgical history - including preventive ovary removal and mastectomy - and hormone use.

Preventive oophorectomy reduces death risk by 77%

Beginning in 1995, the study followed the women through 2011, and researchers looked at the relationship between preventive ovary surgery and the overall death rate by age 70.