Should breast cancer patients have ovaries removed


In some cases, the ovaries (and usually the fallopian tubes) may be surgically removed to treat hormone-receptor-positive breast cancer or as a risk-reduction measure for women at very high risk of breast cancer. This is called prophylactic or protective ovary removal, or prophylactic oophorectomy.

Ovarian Ablation

This procedure is sometimes recommended if you have been identified as carrying a BRCA1 or BRCA2 genetic mutation and have an increased risk of developing ovarian cancer. The surgical removal of your ovaries will reduce circulating estrogens in your body down to postmenopausal levels.


When should ovaries be removed?

“For the last 40 years, the prevailing medical wisdom has been to remove the ovaries if women were 45 or older, in order to prevent ovarian cancer,” says Dr. Parker, Chair of Obstetrics and Gynecology at Saint John’s Health Center and clinical professor at the UCLA School of Medicine.

Why might woman have her ovaries removed?

There are many reasons your doctor may recommend surgery to remove your ovaries. They include: BRCA gene mutations, which are changes in your DNA that make you more likely to have breast or ovarian cancer Endometriosis, a condition where cells that normally grow inside your uterus start growing elsewhere

Why keep ovaries after hysterectomy?

The science

  • The effect on hormones. When a person has both a hysterectomy and their ovaries removed, their estrogen production is dramatically reduced.
  • Early menopause. …
  • Age at time of surgery. …
  • Other complications of estrogen loss. …

Should I remove my ovaries with hysterectomy?

Your doctor may recommend having your ovaries removed when you have a hysterectomy if:

  • You have a BRCA gene change.
  • You have a strong family history of early ovarian cancer.
  • You have a type of breast cancer that estrogen causes to grow.
  • You have severe premenstrual syndrome that could be helped by having your ovaries removed.
  • You have had pelvic pain that involved your ovaries.

Should you get a hysterectomy if you have breast cancer?

There are a large number of doctors who recommended prophylactic hysterectomy and BSO after breast cancer. These doctors will now be reassured and will push even harder for their patients to get into adjuvant surgical menopause.

How much does removing ovaries reduce cancer risk?

Research has shown that premenopausal women who have BRCA gene mutations and have had their ovaries removed reduce their risk of breast cancer as well as their risk of ovarian cancer. The risk of ovarian cancer is reduced by 85% to 95%, and the risk of breast cancer cut by 50% or more.

Why do breast cancer patients get hysterectomy?

In women with an average risk of ovarian and breast cancer, removing the ovaries at the same time as hysterectomy greatly reduces the risk of ovarian cancer and somewhat lowers future breast cancer risk.

Why should ovaries not be removed?

Removing the ovaries may increase your risk of heart disease and osteoporosis. These risks may be higher for people who are younger when their ovaries are removed. If you have your ovaries removed before menopause, you will go into early menopause. You may get hot flashes and other symptoms.

Does removing ovaries decrease breast cancer risk?

In the study by Dr Timothy Rebbeck, of the University of Pennsylvania, and colleagues, the researchers found that women with either of the mutations who had both ovaries removed reduced their risk of ovarian cancer by 96% and their risk of breast cancer by 53% .

What are the chances of getting ovarian cancer after breast cancer?

Results: The 10-year actuarial risk of ovarian cancer after breast cancer was 12.7% for BRCA1 carriers and 6.8% for BRCA2 carriers (P = 0.03). The use of tamoxifen (OR = 1.79; P = 0.16) and chemotherapy (OR = 0.59; P = 0.15) did not significantly impact on the risk of subsequent ovarian cancer.

What are the pros and cons of having your ovaries removed?

The most common reason cited for ovary removal is to prevent ovarian cancer. But there is growing evidence that ovary removal may be associated with an increased risk for heart disease and stroke, and other age-related diseases, such as osteoporosis and even dementia.

What type of cancer requires a full hysterectomy?

A total hysterectomy involves the removal of a woman’s uterus, cervix and surrounding tissue. This procedure may be recommended to treat ovarian and other gynecologic cancers, as well as endometriosis, fibroid tumors, prolapse of the uterus, abnormal vaginal bleeding and chronic pelvic pain.

When should an ovary be removed?

A surgeon may remove one or both of your ovaries for several reasons, including: A disease known as endometriosis, when cells from inside the womb (uterus) travel and grow elsewhere. Benign (non-cancerous) growths known as cysts. Preventative surgery for patients with a high risk of cancer of the breast or ovaries.

Can I have my ovaries removed instead of taking tamoxifen?

If you have a high likelihood of developing estrogen-receptor-positive breast cancer but you don’t want to take hormonal therapy, prophylactic ovary removal could be an option. You have had breast cancer and do not want to take medications that temporarily suppress estrogen production by the ovaries.

What purpose do ovaries serve after menopause?

Although your hormone levels decrease after the menopause, your ovaries continue producing testosterone for up to 20 years. Testosterone is a hormone that plays an important part in stimulating sexual desire and sexual pleasure.

What happens if you remove ovaries?

If you haven’t undergone menopause, you will experience menopause if both ovaries are removed. This deprives the body of the hormones, such as estrogen and progesterone, produced in the ovaries, leading to complications such as: Menopause signs and symptoms, such as hot flashes and vaginal dryness. Depression or …

Can you still get ovarian cancer if you remove your ovaries?

Risk-reducing surgery may be recommended to remove both ovaries for prevention of ovarian cancer. While very uncommon, it’s possible to be diagnosed with ovarian cancer after the ovaries have been removed.

Can I get ovarian cancer if I have no ovaries?

Without ovaries, you can still be diagnosed with ovarian cancer, but your risk is significantly lower.

Can removing ovaries cure ovarian cancer?

Both procedures leave your ovaries intact, so you can still develop ovarian cancer. Total hysterectomy with salpingo-oophorectomy. This procedure removes your cervix and uterus as well as both ovaries and fallopian tubes. This makes ovarian cancer less likely to occur, but it does not remove all risk.

Can ovarian cancer come back after ovaries removed?

If ovarian cancer does recur after surgery, it can present in different ways, either localized to another part of the body, or as a widespread recurrence.

What is the chance of developing breast cancer at age 70?

They can also screen for mutations in BRCA genes that put some women at much higher risk. (Women with a BRCA1 mutation have roughly a 60 percent chance of developing breast or ovarian cancer by age 70.) Some women who have cancer in one breast and are eligible for a lumpectomy followed by radiation opt instead to have both breasts removed in …

Is double mastectomy a cancer treatment?

In California, double mastectomies have become a more popular option to treat patients with cancer in just one breast. In 1998, just 2 percent of those patients underwent a double mastectomy, but in 2011, 12 percent did, according to a recent study published in the Journal of the American Medical Association.

Does double mastectomy reduce breast cancer risk?

IIn the United States in 2011, more than one-third of women younger than 40 who tested positive for a high-risk BRCA1 mutation chose to have a double mastectomy. Preventative double mastectomy doesn’t cut the risk of breast cancer to zero, but it does reduce it by 90 to 95 percent, according to the National Cancer Institute.

Does breast cancer spread to the second breast?

The study found no evidence that the surgery lowered their risk of death compared to more conservative lumpectomy and radiation. Cancer in one breast very rarely spreads to the second, according to Dr. Harold Burstein, a breast cancer specialist at the Dana-Farber Cancer Institute.

Is the watch and wait method more reliable for catching breast cancer than ovarian cancer?

The “watch and wait” method is more reliable for catching breast cancers than ovarian cancers. “We present both of these choices to women with BRCA mutations and usually most women know their own mind,” Burstein said. Learn More About Preventative Surgery to Avoid Ovarian Cancer ».

What happens to the ovaries during menopause?

When a woman goes through menopause, the ovaries stop producing estrogen, but the liver, muscle, and fat will still produce very small amounts of estrogen. Breast cancers can quite often be “estrogen fed,” meaning that estrogen can stimulate the breast cancer to grow.

Do you have to remove ovaries during postmenopausal period?

Maybe. In the postmenopausal woman, there is no need to remove or ablate the ovaries unless the woman has the breast cancer gene. We are forever increasing our knowledge and improving our treatments. Hopefully, one day, we will have found the cure.

Does tamoxifen kill breast cancer?

Instead we use a drug like tamoxifen which, instead of shutting down estrogen production, actually blocks the estrogen receptor on the breast cancer. This prevents the breast cancer from receiving a growth signal and thus the breast cancer will die.

Can breast cancer be ER+?

You will often hear of a breast cancer as ER+. In ER+ breast cancers, we do want to shut down the production of estrogen. In premenopausal women, that is, women whose ovaries are still producing estrogen, it can be very difficult to shut down all estrogen production.

Should Laura have her ovaries removed?

In this case, removing the ovaries will reduce the risk of developing ovarian cancer and if she were to have the breast cancer gene, Laura would be wise to have her ovaries removed once her breast cancer treatments have been completed.

Did Jenny’s friend have breast cancer?

Jenny’s friend, Laura, was just diagnosed with breast cancer and before even seeing the breast surgical oncologist, Jenny told Laura to have her ovaries removed. So, not only was Laura facing the possibility of losing her breasts, now she might need to remove her ovaries as well. Oh, my!

What is the term used to describe treatments that stop the ovaries from making oestrogen, either permanently?

Ovarian suppression is the term used to describe treatments that stop the ovaries from making oestrogen, either permanently or temporarily.

What is the process of producing oestrogen before menopause?

Before the menopause, oestrogen is mainly produced by the ovaries. If the ovaries are removed, or if they are stopped from working, there’s less oestrogen in the body to stimulate the cancer to grow. This is called ovarian suppression. Small amounts of oestrogen will still be produced by fat cells. You will only benefit from ovarian suppression …

What is a dexa scan?

A DEXA scan measures bone density. Whether you’re offered a DEXA scan will depend on which other treatments you’re having. If you’re having ovarian suppression for secondary breast cancer, you can talk to your specialist team about whether a DEXA scan is appropriate for you. 7.

How often is goserelin given?

Find out more about how goserelin is given. Leuprorelin (Prostap) is given as an injection once a month, or sometimes every three months. Triptorelin (Decapeptyl) is given as an injection once a month.

What hormones stimulate breast cancer?

Some breast cancers are stimulated by the hormone oestrogen. This means that oestrogen in the body helps the cancer to grow. This type of breast cancer is called oestrogen receptor positive (ER+). Invasive breast cancers are tested to see if they are ER+ using tissue from a biopsy or after surgery.

How does chemotherapy affect the ovaries?

Chemotherapy can affect the functioning of the ovaries, reducing the number and/or quality of eggs and affecting a woman’s ability to become pregnant.

What should a specialist team discuss?

Your specialist team should discuss what treatment they recommend for you and why.

Why do women have to have their ovaries removed?

In some cases, the ovaries (and usually the fallopian tubes) may be surgically removed to treat hormone-receptor-positive breast cancer or as a risk-reduction measure for women at very high risk of breast cancer. This is called prophylactic or protective ovary removal, or prophylactic oophorectomy. Removing the ovaries is one way …

What is the procedure to remove ovaries?

This is called prophylactic or protective ovary removal, or prophylactic oophorectomy. Removing the ovaries is one way to permanently stop the ovaries from producing estrogen. Medicines also can be used to temporarily stop the ovaries from making estrogen (called medical shutdown). Ovarian shutdown with medication or surgical removal is only …

What is the best medicine for ovaries?

Medicines can be used to temporarily stop the ovaries from making estrogen. Two of the most common ovarian shutdown medicines are: 1 Zoladex (chemical name: goserelin) 2 Lupron (chemical name: leuprolide)

Does removing the ovaries before menopause help?

This benefit occurs only if the ovary removal is performed before menopause. Removing the ovaries before menopause significantly reduces the level of estrogen in a woman’s body. A 2008 study showed that reduction in breast cancer risk after ovary removal is higher in women with an abnormal BRCA2 gene.

Does tamoxifen block estrogen?

While most of the estrogen in a woman’s body is made by the ovaries, smaller amounts of estrogen are made in other parts of the body; a steroid produced by the adrenal glands (androgen) is made into estrogen in fat tissue. This is why you still might take tamoxifen after prophylactic ovary removal — to block the effect of any estrogen in your body.

Can you take tamoxifen after breast cancer surgery?

A 2008 study shows that premenopausal women who had their ovaries removed and took tamoxifen for 5 years after breast cancer surgery had a lower risk of the breast cancer coming back and better survival rates compared to premeno pausal women who didn’t have their ovaries removed and took tamoxifen after surgery. While this is considered aggressive treatment because it puts you prematurely and permanently in menopause, it may be a good treatment option for women who don’t want to have any more biological children or for women who are at high risk for the cancer coming back.

Can breast cancer patients have children?

Women who want to bear children after breast cancer treatment may prefer medical shutdown of the ovaries over surgical ovary removal.

What are the risks of BRCA mutations?

There may be an association with melanoma, an aggressive form of skin cancer. Men who inherit BRCA gene changes also have an increased risk of developing breast or prostate cancer.

What is the risk of developing breast cancer with BRCA1 mutation?

BRCA1 mutations lead to a 55 percent to 72 percent risk of developing breast cancer. The lifetime risk for women with BRCA2 mutations is 45 percent to 69 percent.

What is the chance of getting ovarian cancer?

Women with BRCA1 mutations have a 40 percent to 60 percent chance of being diagnosed with ovarian cancer. Those with BRCA2 mutations have a 20 percent to 35 percent lifetime risk.

What is the best medicine for breast cancer?

Women who have a high risk of developing breast cancer may choose to use more aggressive prevention strategies. Medications like Nolvadex (tamoxifen) are often used to treat breast cancer, but they may also help prevent it.

When should women get their mammograms?

Women who have a high risk of breast cancer should get mammograms earlier and more often. Those considered to be at high risk include women who have a family history of breast cancer, have a BRCA mutation, or have had radiation therapy to the chest. The American Cancer Society suggests that high-risk women start getting yearly mammograms when they turn 30 years old. In addition to mammograms, women with a higher risk may also need to undergo a breast MRI, which creates a more detailed picture of the breast.

Where are inherited gene changes found?

Inherited gene changes are present at birth, and they can be found in every cell within the body. When a person has inherited BRCA mutations, doctors refer to the condition as hereditary breast and ovarian cancer syndrome.

Where does ovarian cancer start?

Ovarian cancer is a cancer that starts in the ovaries, the reproductive glands that produce the…


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