Study underway involving women with a BRCA gene mutation

Doctors have known since the mid-1990s that BRCA genes increase the risk of cancers including breast and ovarian cancers, says Rinki Agarwal, MD, medical director of the Upstate Cancer Center’s gynecologic oncology program and its genetics program.

Removing both the ovaries and fallopian tubes of women with this gene can significantly reduce that risk.

Researchers searching for a way to detect early signs of ovarian cancer have not spotted precursor lesions in the ovaries. However, they have found precursor lesions in fallopian tubes, she says. “That may be where it starts.”

Fallopian tubes preserve fertility. But in addition to their role in fertility, the ovaries produce hormones that impact a woman’s overall health, including mood, sleep, sexual function, cholesterol management, bone health and cardiac function, Agarwal explains. So, preserving a woman’s ovaries would be ideal.

A study supported by the National Cancer Institute is underway – involving some patients from Upstate – to determine whether removing just the fallopian tubes would be adequate in reducing the risk of ovarian cancer. Women at high risk of ovarian cancer can learn about the “Salpingo-Oophorectomy to Reduce the Risk of Ovarian Cancer” study by calling 315-464-8200. Participants must be between age 35 and 50, with the BRCA1 mutation and fallopian tubes intact. Agarwal says as part of the study, women choose between surgery to remove only their fallopian tubes (salpingectomy), or surgery to remove both the fallopian tubes and ovaries (salpingo-oophorectomy).

Normally, the BRCA1 and BRCA 2 genes (BRCA refers to breast cancer) protect against getting certain cancers. But some mutations in these genes prevent them from working properly, so that some, but not all, women who inherit one of these mutations are more likely to get breast, ovarian and other cancers.