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I have a family history of ovarian cancer and I'm worried about developing it myself. Should I have a prophylactic (preventive) oophorectomy?
A prophylactic oophorectomy, the surgical removal of one or both ovaries, is usually reserved for women who are at high risk of developing ovarian cancer. To be considered high-risk, you must have a BRCA1 or BRCA2 gene mutation (both genes have a known link to breast and ovarian cancer) or a strong family history of ovarian cancer. For these high-risk women, having an oophorectomy can significantly reduce the possibility of developing breast and/or ovarian cancer.
That said, the decision to undergo an oophorectomy should not be made lightly. Ovary removal reduces amounts of the hormones estrogen and progesterone that women's cancers need to grow, which results in early menopause. Early menopause carries additional risks including osteoporosis and increased chance of heart disease. And once the ovaries are removed, a woman will not produce any more eggs and therefore can no longer have children naturally.
To make sure you make the right decision for you, consult with your gynecologic oncologist and a genetic counselor.
What percentage of women's cancers have a genetic component? Am I more at risk if there is a history of breast cancer on my mother's side or my father's side?
Based on what we know today, about 5 percent of all cancers, including women's cancers, result from an inherited predisposition to cancer. That means the majority occur independent of a family history and instead are likely a result of environmental or behavioral risk factors.
With new research constantly under way, leaders in Dana-Farber's Center for Cancer Genetics and Prevention believe there are many more cancer genes still to be identified. These discoveries could help researchers understand why some families are more prone to certain cancers, which would lead to better screening or other prevention methods.
If you are concerned that cancer runs in your family, the signs that suggest a hereditary link include:
There is no evidence to show that a history of breast cancer on a mother's side versus a father's side is more significant when it comes to determining cancer risk. When a parent has genetic predisposition to breast or ovarian cancer, each child has a 50-50 chance that the cancer predisposition will be passed along to him or her, according to the National Cancer Institute. It is significant to note, not everyone with a predisposition will develop cancer.
It is important to visit your doctor to get regular Pap smears and mammograms, and to know your family history so you and your doctor can determine a proper screening plan and assess your true risk.
Turning Point 2011