BRCA Mutation And The Decision To Remove Breasts And Ovaries

PITTSBURGH (KDKA) -- Remove the breasts and ovaries -- that's a routine recommendation for women with the BRCA gene, found because of a family history or personal history of cancer in these organs.

"There have been several different studies that have shown that people who have their breasts and their ovaries removed, they can lower their risk to pretty close to what the background risk is for other women," says West Penn Hospital gynecologic cancer specialist Dr. Fred Price.

But how about the uterus?

A study in the Journal of the American Medical Association looked at 1000 women with BRCA1 and BRCA2 mutations who had ovaries and Fallopian tubes removed, but not their uterus.

Eight developed a particular kind of cancer in the lining of the uterus 7 to 13 years later.

Join The Conversation On The KDKA Facebook Page
Stay Up To Date, Follow KDKA On Twitter

Even though it's a small number, this type of cancer {serous/serous-like endometrial carcinoma} has a worse prognosis even when diagnosed early.

"That variant is still very rare," explains Dr. Price. "I don't know reallt that this should change a lot of women's attitudes, because even so, women with BRCA are still at very, very low risk of uterine cancer."

While it may seem like a hysterectomy would not be a big deal to add to surgery to remove the ovaries, there are considerations, including a more complex procedure and a longer recovery.

"When we remove the uterus as well, we're creating a much bigger operation, higher risk of bleeding, infection and other things, changes the anatomy a lot more," Dr. Price says.

Will the study findings increase the number of women getting hysterectomies?

"Now with this information, we're going to have to be a little bit more cautious about recommending not to have a hysterectomy when somebody has a strong family history of breast and ovarian cancer," says Dr. Price.