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Ovary removal boosts survival: procedure shown to benefit women with BRCA mutations.

Surgical removal of the ovaries lessens the risk of death in women carrying BRCA mutations linked to breast and ovarian cancer, a study in the Sept. 1 Journal of the American Medical Association shows. The results also indicate that women undergoing this operation or a mastectomy limit their risk of ovarian or breast cancer, bolstering previous findings that these operations offer long-term protection (SN: 5/25/02, p. 323).

"This is really the first study to show that these women live longer" if they get their ovaries taken out, says Virginia Kaklamani of the Northwestern University School of Medicine in Chicago.

Two BRCA genes encode proteins that protect against cancer. But women carrying a mutated form of either gene face a 50 to 80 percent lifetime risk of developing breast cancer and also have a heightened risk of ovarian cancer.

In the new study, scientists collected genetic data on 2,482 women who were seen by a doctor between 1974 and 2008 and who were eventually shown to have a BRCA mutation. Overall, about two in five had chosen to have their ovaries surgically removed, and roughly one in five had elected mastectomy, says study coauthor Timothy Rebbeck of the University of Pennsylvania School of Medicine in Philadelphia. Some women had both operations. The women were monitored for a median of nearly four years.

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During follow-up, 3 percent of the women who had undergone ovary removal died, compared with nearly 10 percent of women who didn't have the operation. Only 1 percent of women who had the ovary surgery developed ovarian cancer, compared with 6 percent of those who didn't have the surgery. The surgery also decreased the risk of dying from breast cancer, particularly in women who had previously had breast cancer.

The researchers did not calculate mortality in mastectomy patients but did find that among women with no previous history of breast cancer, having their breasts removed as a preventive measure worked: None of these 247 women had breast cancer subsequently. In contrast, 7 percent of those who decided to forgo mastectomy developed breast cancer.

Women who have had breast cancer or have a family history of breast or ovarian cancer, particularly if they are Ashkenazi Jews, should consider getting tested for the BRCA mutation, Kaklamani says. The ovary removal surgery is recommended for mutation-positive women after their childbearing years, she says.

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Title Annotation:Body & Brain; breast cancer
Author:Seppa, Nathan
Publication:Science News
Geographic Code:1USA
Date:Sep 25, 2010
Words:396
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