shadow

Procedures / Operations

Early gynaecological cancers

In Australia, the background risk of Breast Cancer for women is 1:10 (10%) whilst for Ovarian cancer it is 1:100 (1%). Some families however carry a greater risk. For ovarian cancers, these factors include;

  1. Anyone with a personal high risk of Breast cancer
  2. 1 x first degree relative (sister or mother/daughter) with ovarian cancer of Ashkenazi origin
  3. 1 x relative with ovarian cancer AND 1st or 2nd degree relative with Breast cancer under age 50
  4. 2  x relatives on the same side of the family with ovarian cancer
  5. 3 or more relatives of either side with HNPCC associated cancers
  6. Anyone with a high risk of carrying the BRCA or HNPCC gene mutation

Those women with any relative having ovarian cancer or multiple relatives having ovarian cancer on different sides of their family, are at moderately increased risk and have a 12.5-25% chance of cancers.
If a female relative has a breast or ovarian cancer, they can if desired be tested to determine if they carry the abnormal gene. If positive, other family members may choose to be tested to determine their risk. If however you are in one of the high risk groups noted above, you can be tested WITHOUT testing other family members.

What if the test is positive?

  • If you carry the abnormal BRCA-1 gene your risk for ovarian cancer is 36-46%
  • If you carry the abnormal BRCA-2 gene your risk of ovarian cancer is 10-27%

What can be done?

  1. Screening – wait and see approach
  2. Medical therapy – some benefit for reducing risk of ovarian cancer by using the Pill but increased potential risk of breast cancers in BRCA 1 patients
  3. Surgery – tubal ligation
  4. RRSO – risk reducing salpingoophorectomy. Removal of both tubes and ovaries by keyhole surgery reduces the risk of ovarian cancer by 90% and up to 50% reduction of Breast cancer if performed before the menopause
  5. Women who are considering RRSO should strongly consider including the removal of the uterus as well as it allows use of Oestrogen without worrying about endometrial cancers in the future.

It is important to remember that woman carrying this gene do NOT have cancer – the surgery is being done as a prophylactic procedure. As an advanced laparoscopic surgeon, prophylactic TLH (Total laparoscopic hysterectomy) with removal of the tubes and ovaries is routinely performed in this practice.

 

To read a brochure written by Dr Rosen on hereditary gynaecologcal cancers click here

« Back to Procedures