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Removal of ovaries for young women with breast cancer and family history of ovarian cancer

Women diagnosed with breast cancer at a young age who have a family history of either breast or ovarian cancer have a substantially increased risk of developing ovarian cancer compared with women with breast cancer without a family history of either disease, suggest authors of a study published on THE LANCET's website today--www.thelancet.com. Authors of the study recommend that close medical surveillance--and perhaps even removal of the ovaries--might be justified for women at the greatest risk of ovarian cancer.

Around 1% of women in northern Europe and the USA are at risk of ovarian cancer before 70 years of age; the risk is smaller in other developed countries and in less-developed settings. Previous research has suggested that women with breast cancer have a small increased risk of ovarian cancer; this risk is greatly increased in the presence of specific gene mutations (BRCA1 AND BRCA2). However, these gene mutations do not account for all familial breast or ovarian cancers, which (combined with the absence of genetic screening programmes) suggest that other factors--for example the age at onset of breast cancer, and information about a family history of breast or ovarian cancer--might be more useful to identify women with breast cancer at the greatest risk of ovarian cancer.

Kjell Bergfeldt and colleagues from the Karolinska Institute, Stockholm, Sweden, identified over 30,000 women under 70 years of age who had been diagnosed with breast cancer. The investigators obtained information about breast cancer and ovarian cancer for around 146,000 first-degree relatives (parents, siblings, children) of the study population.

After an average of six years follow-up, women with breast cancer were twice as likely to have ovarian cancer than women in the general Swedish population. Diagnosis of breast cancer before 40 years of age substantially increased the risk of ovarian cancer. Women with breast cancer w
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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
27-Aug-2002


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