The term “BRCA” gene comes from “BReast CAncer.” Mutations in the BRCA1 and BRCA2 genes are widely known for their role in raising breast cancer risk. However, these genes also increase the risk of other types of cancer, including ovarian cancer.
Having a BRCA gene mutation means your chances of developing ovarian cancer are higher than the general population. However, there are many preventive steps you can take to lower your risk.
Women in the general population have a 1.3 percent chance of developing ovarian cancer over the course of their lives. In contrast, an estimated 44 percent of women who are BRCA1 mutation carriers and 17 percent of women who are BRCA2 mutation carriers will develop ovarian cancer by the age of 80.
Below, we explore the various preventive steps you can take to lower your chances of developing ovarian cancer if you’re living with a BRCA gene mutation.
Leading medical organizations consider risk-reducing surgery the best treatment to reduce the likelihood that women who carry a BRCA gene mutation will develop ovarian cancer, according to a 2018 research paper in the journal Cancers.
That’s because there’s no reliable method to screen for ovarian cancer. By the time someone is diagnosed, the cancer may have progressed to a point that it’s difficult to treat.
The recommended surgery to reduce ovarian cancer risk is called preventive bilateral salpingo-oophorectomy. The surgery removes the fallopian tubes and ovaries. In turn, it means you can’t become pregnant naturally. For women who carry a BRCA mutation, the surgery can lower the chances of ovarian cancer by 80 percent.
The American College of Obstetricians and Gynecologists (ACOG) advises that women who have a BRCA mutation should consider the surgery when they are between 35 and 40 years old, or when they’re done having children. Waiting a bit longer may be an option for some, but it’s important to discuss the level of risk with your doctor.
The surgery is considered safe, but there are risks. If you haven’t yet reached menopause, this surgery drastically lowers hormone levels in your body, causing immediate menopause. According to the Mayo Clinic, early menopause can increase your risk for osteoporosis and heart disease.
Depending on your age and other factors, you might decide to take hormones after surgery.
There’s no routinely recommended screening test for ovarian cancer. Because of this, medical organizations have different opinions on what’s considered appropriate surveillance.
AGOC suggests that women at high risk of ovarian cancer may consider two screening tests beginning between ages 30 and 35:
- Screening CA-125 serum levels: CA-125 is a protein that can be high in women with ovarian cancer. But this test doesn’t provide certainty. Some women with ovarian cancer won’t have elevated levels of this protein. In addition, other medical conditions can increase CA-125 levels.
- Transvaginal ultrasound: This test can detect abnormalities that might be present in your reproductive organs. Research published in the International Journal of Women’s Health has shown this test isn’t precise enough to be routinely recommended.
Although these screening methods are sometimes recommended, neither has been proven to help with early cancer detection, according to the Mayo Clinic. It’s possible for the tests to come back with normal results, even if cancer is present.
You might consider other preventive options if you want to delay or avoid surgery. It’s important to keep in mind that these options aren’t as effective at lowering the risk of ovarian cancer as surgery, for women who have a BRCA mutation.
Non-surgery options for lowering your chances of developing ovarian cancer include:
- Oral contraceptives. Some research has shown taking birth control pills can lower the risk of developing ovarian cancer by around 50 percent. This is thought to be true both for the general population and for those who have a BRCA gene mutation.
- Chemoprevention. This involves taking medication to lower your risk for developing ovarian cancer. However, there isn’t enough research to recommend chemoprevention in place of surgery in women with the BRCA gene mutation.
If you’ve tested positive for the BRCA gene mutation, you can take steps to reduce your chances of developing ovarian cancer. Preventive surgery is the best option, since it can significantly lower your risk of this cancer.
Other non-surgical options exist to the lower ovarian cancer risk, but none are as effective as surgery. Chemoprevention, birth control, and certain screening tests have been studied and may help. Speak with your doctor about the best preventive options for you.