Preventative surgery is the right option for women with an elevated risk of ovarian cancer, according a new study. Researchers from the University of Manchester have found that, for women with certain high-risk genes, surgery is associated with a significantly higher rate of survival. The study’s recommendations may provide additional guidance for women faced with one of the most difficult decisions they will ever make.
Previous research has revealed that women who carry a fault in the genes BRCA1 or BRCA2 have an elevated risk of dying from cancers of the ovary and breast. This knowledge, along with the widely publicized mastectomies of high-profile celebrities, has led to a surge in so-called risk-reducing surgeries — procedures in which doctors remove the healthy tissue where tumor growth is likely to occur. "Following [Angelina Jolie’s] announcement there has been a three-fold increase in the number of women with a family history of breast and ovarian cancer coming forward asking about surgery,” senior author Gareth Evans explained in a press release. “It really has raised the public awareness of this.”
The current study, which is published in the journal Breast Cancer Research and Treatment, sought to quantify the benefits of this type of surgery. To investigate, the Evans and his colleagues looked at 691 women in whom genetic screening had identified flaws in either BRCA1 or BRCA2. Within this sample, about one-third had subsequently undergone risk-reduction surgery.
The team found that the women who had opted for preventative surgery had an increased survival compared to those who had decided against medical intervention. The surgery group also exhibited an average life expectancy comparable that of a healthy person. “The research shows a major benefit from undergoing risk-reducing surgery, particularly removal of the ovaries and fallopian tubes which reduces the risk of both ovarian cancer greatly and breast cancer by about half," the researcher wrote. "Ideally all women who are at risk should be tested and followed for life to assess the true impact of risk-reducing surgery.”
Today, ovarian cancer ranks fifth in cancer deaths among women. The American Cancer Society estimates that, for all types of ovarian cancers, the 5-year survival rate is 44 percent. However, nascent ovarian tumor growth is very difficult to spot, leading to a general delay in diagnosis. As a result, many cancers aren’t identified until it’s too late.
Source: Sarah L. Ingham, Matthew Sperrin, Andrew Baildam, Gareth R. Evans et al. “Risk-reducing surgery increases survival inBRCA1/2 mutation carriers unaffected at time of family referral.” Breast Cancer Research and Treatment. Volume 142, Issue 3 , pp 611-618