Ovary removal can improve survival for BRCA1 breast cancer patients
August 16, 2013 | by Hiu Chung So
Mutations in the BRCA1 gene are not only associated with a higher risk of developing breast and ovarian cancers, but also increased odds of early-onset and difficult-to-treat tumors as well. However, those carrying a mutated BRCA1 gene may find some hope in a new study that shows their survival to be similar to early-onset breast cancer patients without the gene mutation.
Further, the findings also linked oophorectomy (surgical removal of the ovaries) to lower mortality rates amongst BRCA1 breast cancer patients.
The study, published online in the Journal of Clinical Oncology on Aug. 12, looked at more than 3,000 Polish women diagnosed with early-onset (age 50 of younger) breast cancers, stages I to III. In this study group, 7 percent of the patients were found to carry at least one of three BRCA1 mutations commonly found in Polish population.
After a decade of follow-up and statistical analyses, the researchers have found that the 10-year survival rate was similar between BRCA1 carriers (80.9 percent) and noncarriers (82.2 percent). The survival odds for BRCA1 carriers are even better if the primary tumor is less than 1 cm in diameter (84.6 percent) or diagnosed at Stage I (89.9 percent).
The researchers also found that while chemotherapy improved survival for BRCA1 carriers, oophorectomy also had a dramatic effect – reducing mortality among these patients by 70 percent.
Providing outside commentary on this study in above video, Laura Kruper, M.D., director of City of Hope's Rita Cooper Finkel and J. William Finkel Women’s Health Center, said that many BRCA1 carrying patients “did very well because they had their ovaries removed.”
Kruper also offered an explanation for why ovary removal can improve survival odds for estrogen-resistant breast cancers, which is tied to BRCA gene mutations.
“On one level, it doesn't make sense to remove the ovaries, which make estrogen, and that it would have any impact on estrogen-negative tumors. But it is thought that the estrogen the ovaries make does something ... that feeds the environment that actually allows these cancers to grow,” Kruper said.
While this study’s findings are promising, Kruper said further research is needed because this study only looked at BRCA1 mutations commonly found in Polish women and that outcomes may vary for other mutations. Nonetheless, she does advise BRCA1 carriers to talk to their genetic counselors and physicians about what steps they can take – including oophorectomy – to reduce their cancer risk.