Dr. Margileth explains that since BRCA1 or BRCA2 positive women are at a high risk for breast and ovarian cancers, they should undergo routine breast cancer screenings and consider getting ovaries removed after childbearing.
David A. Margileth, MD:In patients that are BRCA-1 or BRCA-2 positive, a decision is often made to do bilateral mastectomy since their risk of future breast cancer is so high, and more importantly, after childbearing has been completed, those patients should have their ovaries removed because ovarian cancer is a much more serious cancer than breast cancer, and there are really no good screening procedures for cancer in the ovary as there are for breast cancer, like mammography.
All of the tests that have been tried to screen for cancer of the ovary, including CA125, pelvic exams, pelvic ultrasound, trans-vaginal pelvic ultrasound, have not been shown to pick up ovarian cancer commonly at a stage where it might be cured.
So I worry more about women’s ovaries than I do their breasts in the situation of BRCA positivity.
The next issue that is equally important is, if you have a patient that is BRCA positive, one needs to go back to this family tree and ascertain what other family member should be tested. Obviously daughters, obviously sisters, male should be tested because they are at a little higher risk of breast cancer, but more importantly, they can act as a carrier, for instance, to their daughters.
So that’s, not only is the gene testing important in that particular patient but equally important in helping prevent breast cancer, and more importantly ovarian cancer, in other family members of that patient.
Dr. David A. Margileth, MD practices medical oncology at St. Joesph Hospital in Orange, CA specializing in oncology, hematology, and internal medicine (board certified). His selected area of interest is breast cancer. Dr. Margileth graduated from Baylor College of Medicine in 1971 and has since spent time treating patients at the National Cancer Institute and Methodist Hospital in Houston, TX.
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