I am a healthy carrier of the Brca1 mutation and have decided to have my ovaries removed. I have read that this can also decrease the risk of breast cancer. It’s true? Why?
Answers Annamaria Molino, professor at the School of Medicine and Surgery of the University of Verona, former Director of the Complex Operating Unit of Medical Oncology and of the Breast Group at the Integrated University Hospital of Verona.
Dear Madam, I cannot give precise indications in your case, also because I do not know your age and, in general, in this column we try to address the issues from a more general point of view, so that the answer can also be useful for other readers.
Prophylactic removal of the ovaries and tubes, called salpingo-adnexectomy, is commonly proposed to reduce the risk of ovarian cancer, to all women carrying the BRCA 1 and 2 mutation from the age of 35 – 40 and in any case after completing the desire for motherhood. In fact, even if the risk of developing ovarian cancer is lower in women with the BRCA mutation than that of developing breast cancer, the lack of reliable methods of early diagnosis for ovarian cancer leads to consider the intervention of bilateral prophylactic adnexectomy. women carrying this mutation.
Bilateral salpingo-adnexectomy, however, is also able to reduce the risk of breast cancer by 50%, because the surgical removal of the ovaries is followed by a decrease in hormonal exposure. This obviously happens when the surgery is performed in women with still functioning ovaries, that is with the age of 40 or younger and in any case not in menopause.