This October, Dearborn and other cities across the country turned pink in observance of National Breast Cancer Awareness Month; a month dedicated to educating men and women alike about the importance of early detection of breast cancer. With more than 220,000 women in the United States diagnosed with breast cancer in 2011, it is, no doubt, a worthy cause.
But there is another threat to women’s health that is closely linked with breast cancer – and often doesn’t get the same kind of attention: ovarian cancer.
This year, the American Cancer Society estimates that nearly 22,000 women will be diagnosed with ovarian cancer and more than 14,000 will die as a result. Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 73. Her lifetime chance of dying from ovarian cancer is about 1 in 100. (These statistics don’t count low malignant potential ovarian tumors.)
Risk factors for ovarian cancer
There are several important risk factors for ovarian cancer that women should be aware of, including:
- Reproductive history
- Birth control
- Gynecologic surgery
- Fertility drugs
- Estrogen therapy and hormone therapy
- Talcum powder
- Smoking and alcohol use
The link between breast cancer and ovarian cancer
A family history of other types of cancer, including colorectal and breast cancer, is also linked to an increased risk of ovarian cancer. This is because of an inherited mutation (change) in certain genes that causes a family cancer syndrome. About 5 to 10% of ovarian cancers are caused by family cancer syndromes resulting from inherited mutations in two types of genes: the BRCA1 and BRCA2 genes.
The family cancer syndrome caused by a BRCA1 or BRCA2 mutation is linked to a high risk of breast, fallopian tube, primary peritoneal, pancreatic and prostate cancer. It is also responsible for most inherited ovarian cancers. When these genes are normal, they help prevent cancer by making proteins that keep cells from growing abnormally (they act as tumor suppressors). For those who have inherited a mutation in one of these genes from either parent, this cancer-preventing protein is less effective. The lifetime ovarian cancer risk for women with a BRCA1 mutation is estimated at between 35 and 70%.
Who Should Get Tested for BRCA Gene Mutation?
Because BRCA1 and BRCA2 gene mutations are relatively rare in the general population, most experts agree that women without cancer should only be tested when their family history suggests the presence of a mutation. This could include a family history of:
- Breast cancer diagnosed before age 50 years
- Cancer in both breasts
- Both breast and ovarian cancers
- Multiple breast cancers
- Two or more primary types of BRCA1- or BRCA2-related cancers in a single family member
- Cases of male breast cancer
- Ashkenazi Jewish ethnicity – Mutations in BRCA1 and BRCA2 are about 10 times more common in those who are Ashkenazi Jewish than those in the general U.S. population.
Beyond family history, a personal history of breast cancer is another risk factor for ovarian cancer. There are several reasons for this, which may include an inherited mutation in the BRCA1 or BRCA2 genes. Additionally, some reproductive risk factors for ovarian cancer, such as not having children and late onset of menopause, may also affect breast cancer risk. The risk of ovarian cancer after breast cancer is highest in those women with a family history of breast cancer.
What are some benefits of genetic testing for breast and ovarian cancer risk?
The benefits of genetic testing for those at high risk are two-fold:
- A negative result can provide a sense of relief and indicate that special checkups, tests or preventive surgeries may not be needed.
- A positive test result can allow women to make informed decisions about their future, including taking steps to reduce their cancer risk. In addition, those with a positive test result may be able to participate in medical research that could, in the long run, help reduce deaths from breast and ovarian cancer
How can a person who has a positive test result manage their risk of cancer?
Several options are available for managing cancer risk in individuals who have a known
BRCA1 or BRCA2 mutation. These include enhanced screening, prophylactic (risk-reducing) surgery and chemoprevention. Oral contraceptives may also lower the risk of ovarian cancer in women with BRCA1 or BRCA2 mutations.
If you or your family have a history of breast cancer or other types of gynecologic cancer, be sure to talk to your physician about your risk for ovarian or other cancers. Also, don’t forget about the importance of screenings – while there is no screening specific to ovarian cancer, an annual mammogram for women over 40 (or younger, depending on family history) is an important step toward early detection and overall health maintenance.