Women get help with tough choices to avoid breast and ovarian cancer

March 22, 2012 | by City of Hope Staff

Certain genes can raise a woman’s risk of developing breast and ovarian cancer. When women find out they carry these gene mutations, they face a painful decision: Many choose to have their breasts and ovaries removed to avoid cancer.

Photo of Deborah MacDonald Deborah MacDonald

That decision also means they’ll go into menopause early — something that can dramatically change their life. City of Hope researchers now are studying how these surgeries affect women’s psychological and social well-being to help them cope.

Deborah MacDonald, Ph.D., R.N., A.P.N.G., assistant professor in the Division of Clinical Cancer Genetics, understands the issues these women may face, particularly if they are younger. “Early removal of healthy ovaries forces many women to accelerate or abandon childbearing and to enter menopause abruptly and at a younger age than their peers,” MacDonald said.

Her study focuses on women with what are called BRCA1 and BRCA2 mutations. Here’s how these mutations affect a woman’s lifetime risk of cancer:

Proportion of women with a mutation in either gene who will develop this cancer in her lifetime:

  • Breast cancer: 50 to 80 percent
  • Ovarian cancer: 15 to 50 percent

Proportion of women as a whole who will develop this cancer in her lifetime:

  • Breast cancer: 12 percent
  • Ovarian cancer: 1.5 percent

MacDonald and her colleagues at City of Hope have found that women who have preventive surgery often struggle with the decision because they’re worried about the impact on sexuality, intimacy, fertility and other factors related to early menopause. Unfortunately, researchers haven’t explored these issues to fully understand or meet these women’s needs, she said.


Supported by a grant from the American Cancer Society, MacDonald will interview women with these mutations and then create and test ways to better inform and prepare these women for making decisions associated with their cancer risk.

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