Penn researchers find ovary removal reduces risk of breast cancer in women withBRCA1 mutation

September 01, 1999

(Philadelphia, PA) -- Women carrying a mutation in the BRCA1 gene can cut their breast cancer by 70 percent by undergoing a bilateral prophylactic oophorectomy (BPO), or removal of their two ovaries, say researchers at the University of Pennsylvania Cancer Center. These findings are published in the September 1, 1999 issue of the Journal of the National Cancer Institute.

"This is the first study demonstrating a surgical approach to breast cancer risk reduction among BRCA1 mutation carriers," says Tim Rebbeck, PhD, associate professor of epidemiology and principal investigator of the study. "Although we're talking about a small percentage of women in the breast cancer population, these findings may have an impact on the clinical management of women carrying BRCA1 mutations."

In the study, Rebbeck and his colleagues looked at the medical histories of 122 women with a BRCA1 gene mutation, a group that is considered "at-risk" for developing breast cancer. Knowing that the majority of women with the BRCA1 mutation may develop breast cancer by the age of 70, the researchers compared the occurrence of breast cancer among the 43 women who had had their ovaries removed to the 79 women who had not. None of the women had a personal history of breast or ovarian cancer and all of women were matched according to age (the average being 37).

After following the women's health history for more than 10 years after the BPO, the researchers determined that the incidence of breast cancer in the women who had the BPO was reduced by 70 percent.

"These results demonstrate that having a bilateral prophylactic oophorectomy clearly reduces a woman's risk of breast cancer if she is a carrier of the BRCA1 mutation," says Rebbeck. "We caution, however, that the procedure does not completely eliminate the risk of the disease." In Rebbeck's study, ten women who underwent BPO subsequently developed breast cancer.

The researchers looked at women who had a BPO because ovaries produce estrogen, a hormone associated with the growth and development of breast tumors. By removing estrogen exposure to the breast, clinicians surmised that a woman's chance of getting breast cancer would lessen. "BPO would most likely benefit a pre-menopausal woman. However, we ultimately hope to identify a non-surgical means of achieving the same result, and we highly advocate that any woman considering a bilateral prophylactic oophorectomy get counseling before undergoing the procedure," he concluded.
Editor's note: Dr. Rebbeck is available at (215) 898-1793 or call Sue Montgomery in the Public Affairs office at (215) 349-5657.

University of Pennsylvania School of Medicine

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