Memorial Sloan Kettering experts discuss ovarian and breast cancer prevention and treatment in women with a BRCA mutation.
There is no way to guarantee that you won’t develop cancer in your ovaries, peritoneum (a layer of tissue that lines your abdomen), or fallopian tubes. Most women have an approximately 1 in 70 chance of being diagnosed with one of these three cancers at some point in their lives. Aging is one risk factor; average age at diagnosis is 62.
Being aware of your risk level can help you make more-informed decisions about what to do to protect yourself and other family members.
Approximately 5 to 10 percent of women diagnosed with ovarian cancer have inherited an increased risk for the disease, which means that the cancer runs in the family. Risk is increased if a blood relative such as a mother, sister, grandmother or aunt has had ovarian cancer.
You are at a risk level near that of the general population if you have:
- no family history of breast or ovarian cancer
- a personal history of breast cancer diagnosed at age 41 or older
- no Ashkenazi Jewish heritage (individuals of Eastern European Jewish descent)
- a history of infertility and/or use of assisted reproductive therapies, such as in vitro fertilization (IVF)
- a history of endometriosis (a condition in which tissue from the lining of the uterus grows outside of the uterus)
- a history of hormone replacement use for the management of symptoms related to menopause
You are at increased risk if you have:
- a family history of ovarian or breast cancer
- a personal history of breast cancer prior to age 40
- a personal history of breast cancer diagnosed prior to age 50 as well as one or more close relatives diagnosed with breast or ovarian cancer at any age
- two or more close relatives diagnosed with breast cancer prior to age 50, or with ovarian cancer diagnosed at any age
- Ashkenazi Jewish heritage and a personal history of breast cancer prior to age 50
- Ashkenazi Jewish heritage and a first- or second-degree relative diagnosed with breast cancer prior to age 50, or with ovarian cancer at any age
You are at high risk — one in five or higher — if you inherited certain mutations in genes that are involved in cell growth, division, and DNA repair:
- the BRCA1 or BRCA2 genes (relative risk for ovarian cancer is greater than six times that of the general population)
- a mismatch repair gene mutation associated with a hereditary cancer syndrome known as Hereditary Non-Polyposis Colon Cancer (HNPCC)/Lynch syndrome
Other factors that can generally increase risk for ovarian cancer include:
- early menstruation or late menopause
- endometriosis, a condition that involves tissue from the lining of the uterus growing outside the organ
In addition to the basics of following a healthy lifestyle by eating well, staying active, and maintaining your target weight, factors that may lessen the risk for ovarian cancer include:
- Pregnancy. Never having been pregnant or given birth reduces the risk of developing ovarian cancer.
- Oral birth control. The longer a woman takes birth control pills, the more she’s protected against developing ovarian cancer. This protection appears to last for many years after last taking the pill. However, because oral contraceptives also pose some risks, you should speak with your doctor for help in deciding if this is a good choice for you.
- Tubal ligation. Having your “tubes tied” may lower your risk for ovarian cancer, but MSK experts emphasize that the procedure should be performed with the intention of preventing pregnancy — not reducing ovarian cancer risk.
Measures to Prevent Ovarian Cancer for Women at High Risk
Some women at high risk for ovarian cancer as a result of a family history decide to have surgery to remove the ovaries and fallopian tubes, in an effort to prevent the disease. The procedure, called salpingo-oophorectomy, is one in which MSK has particular experience and expertise.
Our genetics counselors may also recommend prevention strategies for women at high risk. Our surgeons are also investigating whether removing the fallopian tubes only, without removing the ovaries, may similarly reduce the risk of ovarian cancer.