Study: Preventive Cancer Surgeries Save Lives

(CBS)  Women who know they're at high risk for developing ovarian or breast cancer can dramatically lower their risks of developing the diseases if they get their healthy ovaries or breasts surgically removed, new research shows.

The study, which appears in Wednesday's edition of the Journal of the American Medical Association (JAMA), involved BRCA1 and BRCA2, which are human genes, CBS News Medical Correspondent Dr. Jennifer Ashton explained on "The Early Show."

Ashton, a practicing obstetrician/gynecologist, said mutation of those genes has been linked to about 10 percent of hereditary breast and nine percent of hereditary ovarian cancer. Women carrying the mutations have a risk five times greater of getting breast cancer than those who don't, and a risk at least 10 times higher for ovarian cancer.

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Researchers followed nearly 2,500 women with BRCA mutations in four countries for an average of four years. At the start, they were all cancer-free, and most were younger than 50.

The study found that women who chose to have their healthy ovaries and fallopian tubes surgically removed not only lowered their risk for ovarian cancer, but breast cancer, as well. Women who underwent prophylactic mastectomy reduced their risk for breast cancer.

The researchers found that the women with the BRCA mutation who had the operations decreased their risk of dying of both types of cancer by 70-to-80 percent.

"This study was ground-breaking, because it was the first one that showed that (such surgeries) saved lives," Ashton observed to co-anchor Erica Hill.

"When you talk about preventive surgery or risk-reducing surgery, you have to take into account not just the risks of the procedure, but the age of the patient," Ashton pointed out. "Have they had children? Do they want future children? And also, what are the consequences of that surgery? When you talk about taking out someone's ovaries, early menopause has its own set of risks. It's not a simple discussion. It's something I go through with my patients over hours. I've done the surgery (in which) I removed the ovaries, but it's not an easy decision."

But, Ashton added, there are alternatives for women who don't want to have the preventive surgery.

"When you talk about screening for breast cancer," Ashton said, "this is reducing risk so you never get the cancer. When you talk about surveillance for cancer, for breast cancer, obviously, things like mammography, MRI, ultrasound, those are used more and more in younger women and high-risk women. That's an option. That's talking about early detection versus prevention."

Ashton continued, "There is no accepted screening test for ovarian cancer. We can't biopsy the ovaries. What we have now at our disposal is really pelvic sonograms, certain blood tests, like the HE-4, CA-125 or a new one, called OVA-1. They're not perfect tests. They're not 100 percent accurate. They can detect cancer, but they can also give what are called false-positives, and be abnormal when there is no cancer there. So, it's very difficult when you talk about screening for ovarian cancer."

Screening for the BRCSA mutation "is such a simple test to do," Ashton said. "It's a blood test. You can get it at your gynecologist, your oncologist (cancer specialist), genetic specialists do it. It is expensive. But if you are at high risk, most of the time, insurance companies will pay for it.
"There are some red flags. No. 1 -- if are you of Eastern European Jewish background, male or female, because men can pass this to their daughters."

Men get breast cancer, too.

Other indicators you should be screened:

* Two first-degree relatives with breast cancer, one of whom was diagnosed before age 50
* Three or more first- or second-degree relatives with breast cancer, diagnosed at any age
* Both breast and ovarian cancer in the family
* A first-degree relative with cancer in both breasts
* Two or more relatives with ovarian cancer
* One relative with both breast and ovarian cancer
* A male relative with breast cancer