What can carriers do to actively prevent developing breast and ovarian cancer?
Unfortunately, the tools at our disposal for gynecological screening have not been shown to be effective enough in the early detection of ovarian and fallopian tube tumors. Therefore, we recommend that BRCA mutation carriers consider risk-reducing surgeries. This includes the resection of ovaries and fallopian tubes from age 35-40, after completing fertility programs.
Performing preventive ovarian resection reduces the risk of developing this cancer from a rate of approximately 50% to a rate of 1-2% throughout life. When ovarian resection is done around age 40, it also reduces the risk of developing breast cancer from 75% to 40%. Bilateral preventive mastectomy reduces the risk of developing breast cancer by 90%.
Another preventive measure is the use of birth control pills, which significantly reduces the risk of ovarian, fallopian tube, and peritoneal tumors. Several significant British studies have also demonstrated a decrease in mortality from ovarian and uterine tumors amongst women taking contraceptive pills. Controversy exists in the medical literature regarding the effect of birth control pills on the risk of breast tumors. While various studies present conflicting findings, it does not appear that the use of pills involves a significant increase in the risk of breast tumors. Therefore, in young carriers of the BRCA gene mutation, contraceptive pills are the drug of choice.