Every year, one million women around the world are diagnosed with breast cancer, and almost 200,000 others are told they have ovarian cancer. The decisions for treatment are more difficult when the women carry genetic mutations called BRCA1 and 2, mutations that could also increase a woman's risk for cervical, uterine, pancreatic and other cancers. A recent study shows that women who undergo preventive surgery reduce their risk for breast and ovarian cancers.
Sandra Cohen has never had breast or ovarian cancer, but she had surgery to remove her breasts and ovaries. She made the decision to undergo surgery after her grandmother and mother both died from the same type of cancers.
"It's kind of like you are sitting on a time bomb waiting for cancer to occur," she says, "and it really does a number on you mentally to deal with that every single day."
Doctors have known for years that preventive surgery reduces the risk of ovarian and breast cancer for women like Cohen who carry the BRCA1 or BRCA2 mutations.
But a recent study also shows the surgery helps those patients live much longer.
Dr. Susan Domchek at the University of Pennsylvania School of Medicine co-authored a four-year study of about 2,500 women with the genetic mutations BRCA1 and BRCA2.
"Women who had their ovaries removed had a decrease in the risk of breast cancer, a decrease in the risk of ovarian cancer, and in addition, they were less likely to die of breast cancer," she explains, "less likely to die of ovarian cancer and also had an improvement in their overall survival."
None of the women who had preventive mastectomies developed breast cancer. Seven percent of those who refused the surgery were later diagnosed with the disease.
The rate of breast cancer among women who had ovaries removed was also much lower (one percent) than for those who did not have the surgery (seven percent).
The study also showed that women who had ovarian surgery dramatically reduced their risk of death from ovarian cancer by almost 80 percent and from breast cancer by 56 percent.
"Our conclusion is that removing the ovaries particularly is very beneficial to women with BRCA1 and BRCA2 mutations," Dr. Domcheck said.
The researchers concluded that women with a strong family history of breast or ovarian cancers should be encouraged to get genetic testing.
Sandra Cohen was tested, and she has advice for others with a similar history. "Do some research with a genetic counselor. Meet other women who have gone through it. It really will empower you," she says, "and give you the strength to take some action."
The study appeared in the Journal of the American Medical Association.