Uterine cancer might be in the future of people who have the BRCA1 gene and have had a preventative surgery. A recent study examined 525 women who had the BRCA1 or BRCA2 mutated genes that had risk-reducing salpingo-oophorectomy, a preventative surgery to remove their ovaries. 168 of these women did not have a history of breast cancer and 357 did have a history of breast cancer. 56 percent of the women had the BRCA1 mutation, 43 percent had the BRCA2 mutation and .6 percent had neither mutation. The study was presented at the yearly meeting of the Society of Gynecologic Oncology and run by the Memorial Sloan Kettering Cancer Center located in New York. The study found that women had a high risk of developing uterine cancer after they had the preventative surgery.
Noah D. Kauff, a doctor of medicine, the senior author of the study and the director of ovarian cancer screening and prevention on the gynecology service at Memorial Sloan Kettering Cancer Center, said in a press release that while the definite risk is low, it is still higher than physicians would have expected for these types of aggressive uterine cancers. Kauff also said that doctors should tell their patients who have the BRCA1 gene that the study suggests they might be at risk for rare types of aggressive uterine cancer. He continues by saying that whether or not a woman decides to have a hysterectomy when they had risk-reducing salpingo-oophorectomy might depend on past cancer history, age and other risk factors. The researchers used race and age specific hysterectomy adjusted SEER to find out the expected uterine cancer incidence.
Four women out of the 296 who did not have their uterus removed and had the BRCA1 mutation developed an aggressive form of uterine cancer. This result translates into a 2.1 percent increase of developing uterine cancer within the first 10 years of having risk-reducing salpingo-oophorectomy. That is about a 26-fold increased risk as compared to what is expected in the general population. All four cases of uterine cancer were high risk including two that were serious: one was leiomyosarcoma and the other was carcinosarcoma. These cases of cancer were diagnosed in women with the BRCA1 mutation 1.4 to 12.9 years after receiving the preventative surgery. The predicted number of high risk uterine cases was 0.28 which equated to a 1.8 observed-to-expected ratio.
The study did not find a high risk for the most common types of uterine cancer. It also found that the high risk of ovarian cancer might be associated with a past history of breast cancer or the use of a breast cancer drug called tamoxifen as well as a combination of both. Findings showed that women who had BRCA2 did not develop uterine cancer. Dr. Karen Lu, a specialist in women’s cancers at the MD Anderson Cancer Center in Houston, said that it is important for women to have this information but that it is too soon for doctors to recommend that patients have a hysterectomy until more research confirms the results.
A study that was reported at the yearly meeting of the Society of Gynecologic Oncology found that women who had the BRCA1 gene had a high risk of developing uterine cancer even after they received the preventative surgery, risk-reducing salpingo-oophorectomy. Out of the 296 women who had the BRCA1 gene, four of them developed uterine cancer and two of those women developed serious forms of uterine cancer. The study found that women who had the BRCA2 gene did not develop uterine cancer. Lu plans to study patients in her cancer center to see if they have a high risk of the cancer.
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