Ovarian cancer (hereditary or familial)

Ovarian cancer is a type of cancer that begins in one or both ovaries. 5% of all cases of ovarian cancer are hereditary. This type is a result of a mutation in the BRCA1 or 2 genes. People with an altered BRCA1 gene have a 30 to 60% chance of developing ovarian cancer – we refer to this type of cancer as hereditary ovarian cancer. Damage to the piece of DNA (the hereditary material called the gene) responsible for the production of BRCA1 or 2 proteins, means a 5-20% chance of ovarian cancer; this, too, is considered a hereditary form of ovarian cancer.

If ovarian cancer occurs in two or more family members but there is no gene mutation found, the risk of developing ovarian cancer is lower, but still over 10%. We call this a familial form of ovarian cancer.

Diagnosis

Women with a hereditary risk of developing ovarian cancer due to a mutation in the BRCA1 or 2 gene are advised to regularly come in for preventive breast examinations.

Ovarian cancer is often caught in a later stage due to the lack of early-stage symptoms. We still do not have adequate screening methods for this cancer type. Recent studies have shown that yearly ovarian cancer screenings through gynecological examination, transvaginal ultrasounds, and the tumor marker CA-125 do not lead to the early detection of ovarian cancer.

Gynecological support and recommendation for oviduct or ovary removal will generally take place after the age of 35. Prior to the surgery, you will undergo gynecological examinations such as:

  • Internal pelvic examination
  • Transvaginal ultrasound
  • Blood tests for tumor marker CA 125

If one or more of these examinations will show any abnormalities, more specific testing can be done, such as:

  • CT scan
  • Diagnostic laparoscopy

Treatment

Preventive surgery

Carriers of a mutated BRCA1 of 2 genes and women with 2 or more relatives with ovarian cancer are recommended to preventively remove the ovaries. Preventive surgery usually occurs around the age of 35-40 in the case of a BRCA1 mutation, and 40-45 in the case of a BRCA2 mutation or two or more family members with ovarian cancer.