Removal of ovaries in women after breast cancer diagnosis with a mutation in the BRCA1 gene, a known risk factor for developing breast cancer, was associated with a significant reduction in cancer deaths in a study in JAMA Oncology. With Angelina Jolie, who carries the BRCA1 mutation, writing in the New York Times about her decision to have her ovaries removed, GENeS asked experts to analyze the risks as reported in the study.
Dr. Brian J. Zikmund-Fisher, Associate Professor in the Department of Health Behavior and Health Education, University of Michigan School of Public Health (webpage):
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“The absolute risk reduction suggested by the results of this study appears substantial: Out of 100 women with known BRCA1 mutations, perhaps 10 or more of them (depending on characteristics) appear to avoid death in the first 10 years due to removing their ovaries quickly after their breast cancer treatment.”
Dr. Andrew Maynard, Professor of Environmental Health Sciences & Director of the Risk Science Center, University of Michigan (webpage):
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“This is a study on the effectiveness of surgery to remove the ovaries after diagnosis of breast cancer – it doesn’t directly provide evidence of reductions in risk of developing breast cancer associated with ovaries removal prior to diagnosis. The study provides evidence that, when women with inherited mutations in the BRCA1 gene develop breast cancer, removal of the ovaries subsequent to diagnoses reduces the chances of dying as a result of the cancer by 62%, compared to the the chances of dying without having the ovaries removed. In other words, according to the study, if a woman is diagnosed with breast cancer and has an oophorectomy (surgical removal of her ovaries), if she has the BRCA1 mutation, her chances of dying as a result of the cancer are more than halved compared to not having the surgery.
“In contrast, the study did not find significant evidence of a similar reduction in the risk of dying in women with the BRCA2 mutation. However, this may have been due to the relatively small number of women in the study with the BRCA2 mutation.
“The authors do point out that breast cancer diagnosis and treatments have improved since women started being recruited into the study cohort in 1975, and so the current survival advantage associated with oophorectomy in women diagnosed with breast cancer and having the BRCA1 mutation may be lower than indicated by the analysis.”
‘Removal of Ovaries Associated with Decrease in Breast Cancer Death in Women with Breast Cancer and BRCA1 Mutation’ by Narod, Kelly et al, published in JAMA Oncology on Thursday, April 23, 2015.
Declared interests (see GENeS register of interests policy):
No interests declared