An article published in “Menopause” has reviewed current information relating to the effect on breast cancer risk for women who carry the BRCA gene and the use of HRT after removal of ovaries for risk-reducing surgery.
BRCA1 gene is associated with risk of breast cancer by age 70 of 60% to 65% and of ovarian cancer of 39% to 59%. BRCA2 gene is associated with risk of breast cancer by age 70 of 45% to 55% and of ovarian cancer of 11% to 17%.
It is known that removal of both ovaries and fallopian tubes in pre-menopausal women reduces ovarian, fallopian tube and peritoneal cancer risks by 72% to 80%, and reduces breast cancer risks by 46% to 48% in these women. However, it is also known that the early or premature menopause which then ensues can cause significant menopausal symptoms and detrimental effects on bone, heart and brain health.
The article explains that studies so far have shown that the risk of breast cancer is not increased with the use of HRT after risk-reducing surgery and that young women should not avoid risk-reducing surgery because of fear of the need for and the effect of HRT after the surgery. However, studies are limited and further research is required.
Reference: Use of Systemic Hormone Therapy in BRCA Mutation Carriers. Domchek S, Kaunitz A M. Menopause 2016;23(9):1026-1027