Advertisement

From the Doctor's Corner: Good news about genetic cancer risks

Examples of Jolie, Brosnan can teach, empower women about their health choices.

July 11, 2013|By Jane K. Bening, M.D

The recent disclosure by actress Angelina Jolie that she had undergone elective bilateral mastectomies to reduce her risk of breast cancer provides an opportunity to understand the science behind the BRCA gene mutation she carries. Jolie's mother died in 2007 of ovarian cancer at age 56, an indication for Jolie to consider BRCA gene mutation testing.

Also in the news is the recent passing of Pierce Brosnan's 41-year-old daughter, Charlotte Brosnan, from ovarian cancer. Charlotte's mother, Brosnan's deceased wife Cassandra Harris, died of ovarian cancer in 1991. Cassandra's mother had also died of this deadly disease. Here, we see the tragic consequences of the potential heritability of the risk of ovarian cancer. This provides a teachable moment. Knowledge about genetic cancer risk can empower women to make health choices that may save their lives.

The BRCA gene mutations (named for BReast CAncer risk) are associated with a marked increase in the risk of breast and ovarian cancer. The average woman has a 12% risk of breast cancer and a 1.4% risk of ovarian cancer during her life. Carrying a BRCA gene mutation raises the risk of breast cancer to 50-85% and the risk of ovarian cancer to 10-63%. Ovarian cancer is particularly dangerous, because there are no good screening tests, and it has often spread beyond the potential to cure when diagnosed.

Advertisement

Fortunately, preventive surgeries, such as double mastectomies and removal of the tubes and ovaries, have been shown to reduce cancer risks and lower mortality in carriers of the BRCA gene mutations. A large study by Domchek, SM, et al, published in the Sept. 1, 2010, issue of the Journal of the American Medical Assn., provides encouraging findings. For example, risk-reducing (prophylactic) removal of the tubes and ovaries in women with BRCA mutations was associated with a 76% drop in all-cause mortality.

There is other good news.

Hormonal contraceptives markedly reduce the lifetime ovarian cancer risk in all women, including carriers of the BRCA gene mutations, by 50% when taken for just four years. Under the Affordable Care Act, generic birth control and the vaginal contraceptive ring are completely covered by health insurance. With greater access to these medications, we should see ovarian cancer rates continue to drop nationwide, along with a reduction in unwanted pregnancies.

Coastline Pilot Articles Coastline Pilot Articles
|
|
|