For those of us who have been affected by breast cancer either directly or indirectly, we know just how devastating it can be to go through. It can change your whole life in an instant. Looking back, or even right now, if you could increase your chances of survival, would you remove your ovaries?
Removal of the ovaries, a procedure known as an oophorectomy, was associated with a 62 per cent reduction in breast cancer death in women diagnosed with breast cancer and carrying a BRCA1 gene mutation, according to an article published online by JAMA Oncology.
For those women who carry either the BRCA1 or BRCA2 gene mutation, they face a lifetime risk of breast cancer – up to 70 per cent more than those without the variation in genomes. And once they are diagnosed with breast cancer, the fight is not over as they face high risks of both second primary breast and ovarian cancers.
A study of 676 women, of whom 345 underwent oophorectomy after being diagnosed with breast cancer, and 331 women retained both ovaries, found the 20-year survival for the entire group was 77.4 per cent. Overall, there was a 56 percent reduction in breast cancer death associated with oophorectomy. Undergoing an oophorectomy was associated with a 62 percent decrease in breast cancer death in women with a BRCA1 mutation, although not in women with a BRCA2 mutation – the 43 per cent reduction that the authors found was not statistically significant.
Sadly, in the case study, nine women died from ovarian cancer in the group of women who did not have their ovaries removed after being diagnosed with breast cancer. From this data, authors Steven A. Narod, M.D., and Kelly Metcalfe, Ph.D., of the Women’s College Research Institute, Toronto, Canada, and coauthors found a 65 per cent reduction in all-cause mortality associated with oophorectomy in their analysis.
The authors note the protective effect of oophorectomy on deaths from breast cancer was apparent immediately after diagnosis and lasted for 15 years.
“It is important that follow-up studies be performed on women who undergo oophorectomy as part of their initial treatment, in particular, those women who undergo oophorectomy in the first year after diagnosis. It is also important that our observations be confirmed in other study populations” article concludes.
Editor-in-chief of JAMA Oncology, Mary L. Disis, M.D., wrote in response: “The results provide a validation of the role of oophorectomy in conveying both a disease-free and overall survival benefit for BRCA1 mutation carriers. Oophorectomy after the primary diagnosis of breast cancer significantly reduced breast cancer-specific mortality in women with BRCA1 mutations but not in BRCA2 mutation carriers. In the entire group, oophorectomy was particularly effective for survival benefit in women with estrogen receptor-negative breast cancer”.
Tell us below, have you heard of this method of protection for future cancers after breast cancer? Would you have done it if you had known? How has breast cancer affected your life or someone close to you?