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Hormone therapy and breast cancer risk after ovary removal in women with a BRCA1 mutation

https://www.facingourrisk.org/XRAY/hormone-therapy-after-ovarian-removal
Full article: https://jamanetwork.com/journals/jamaoncology/article-abstract/2678466

Does hormone therapy (HT) alter the risk of breast cancer for woman carrying a BRCA1 mutation who have never been diagnosed with cancer? In this study, researchers showed that among women with BRCA1 mutations, HT use did not increase breast cancer rates for 10 years after ovary removal. More women taking combined estrogen plus progesterone developed breast cancer compared to those taking estrogen only, though this difference was not statistically significant. (9/7/18)

Expert Guidelines

The National Comprehensive Cancer Network (NCCN) creates guidelines for the management of risk in women at high risk for cancer. 

Guidelines for oophorectomy in high risk women

Guidelines for hormone replacement after salpingo-oophorectomy in high risk women

In their guidelines NCCN also states that hormone replacement therapy in women who have RRSO does not negate the reduction in breast cancer risk associated with the surgery. However they do highlight the limitations of the existing research .

The North American Menopause Society is a professional society of experts in the field of menopause. In 2017 they released a position statement on hormone replacement therapy, which includes the following: 

Specific to women with BRCA1 or BRCA2 mutations who have removed their ovaries to lower their risk for cancer, they include the following:

Questions To Ask Your Health Care Provider

 

Open Clinical Trials

NCT03815929: Oophorectomy, Estrogen Therapy and Cardiovascular Disease Risk in Young Women. Researchers are trying to assess the best dose of estrogen for decreasing heart disease in women who have removed their ovaries before the age of 46.

NCT02760849: Surgery in Preventing Ovarian Cancer in Patients With Genetic Mutations (WISP Study). The goal of the WISP Study is to compare whether removal of fallopian tubes only, delaying removal of the ovaries can safely improve sexual functioning and menopausal symptoms compared to standard risk-reducing removal of the ovaries and fallopian tubes (also known as risk-reducing salpingo-oophorectomy or RRSO).

About FORCE

FORCE is a national nonprofit organization, established in 1999. Our mission is to improve the lives of individuals and families affected by adult hereditary cancers.