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Breast cancer survivors who have a BRCA mutation or hereditary breast cancer are at higher risk for ovarian cancer than breast cancer survivors with sporadic breast cancer. Panel genetic testing can reveal mutations in other genes that increase ovarian cancer risk such as BRIP1, RAD51C, and RAD51D.
A research study on ovarian cancer risk in breast cancer survivors with a BRCA mutation found a 12.7% risk in BRCA 1 carriers and 6.8% risk in BRCA 2 carriers within 10 years of the breast cancer diagnosis. The same study also concluded that BRCA mutation carriers with early-stage breast cancer benefit from risk-reducing oophorectomy. Research on the ovarian cancer risk for women with mutations in BRIP1, RAD51C, and RAD51D is ongoing.
Women who undergo oophorectomy prior to natural menopause will experience menopause as a result of the surgery. Menopausal symptoms vary from woman to woman and some of the consequences of menopause are more serious than others. For more information on surgical menopause, please visit our section on this topic.
Not all breast cancer survivors who carry mutations that increase ovarian cancer choose risk-reducing surgery. Women who are still in treatment for breast cancer, those who are concerned about early menopause, and women who are considering having children after breast cancer have options other than oophorectomy. The options include:
Women with a family history of breast and ovarian cancer but no identified mutation associated with hereditary cancer have an elevated risk of ovarian cancer after breast cancer, but the exact risk is unknown. For those women with breast cancer who have a family history of breast cancer only, (no ovarian cancer in the family) but no known mutation, the risk for ovarian cancer may not be elevated above the risk for the general population. One study on women from families with an extensive history of breast cancer but without a BRCA mutation found the risk for ovarian cancer was no higher than for women in the general population.
Risk management decisions are highly personal. If you are at high risk for ovarian cancer, you need a clear sense of your own personal risk and an understanding of the potential benefits, risks, and side effects of each risk management option. Genetic experts can help breast cancer survivors who have an inherited mutation in a gene that increases cancer risk, a family history of cancer, or other indicators of hereditary cancer determine their risk for ovarian cancer and develop a risk management plan. Continue to keep in touch with a genetics expert for updates on current knowledge.