Less than 3% of cancer in women is ovarian in nature, but ovarian cancer accounts for more deaths than any other cancer of the female reproductive system. Epithelial ovarian cancer is the most common type of ovarian cancer accounting for 90% of ovarian cancers.
All patients with invasive epithelial ovarian cancer should be offered genetic counseling/testing, as the results can impact their family member’s health. Germline BRCA1 and BRCA2 mutations, meaning mutations that can be inherited, account for at least 15% of invasive ovarian carcinomas. BRCA1 and BRCA2 mutations increase the lifetime risk of ovarian cancer to 15-50% compared to the lifetime risk for a woman in the general population of 1.5%. BRCA genes are inherited in an autosomal dominant pattern meaning that if a parent carries a mutation, his/her child each has a 50% risk of inheriting that mutation.
Importantly, not only women are affected by BRCA mutations. Men with these mutations have a higher risk for breast cancer, prostate cancer, pancreatic cancer, and possibly melanoma. Genetic testing information can help family members know more about their cancer risks, and their options for risk reduction and surveillance for this, and other, cancers.
There are also other gene mutations associated with an elevated risk to develop ovarian cancer and many panels now include these other genes. Genetic testing is not always straightforward: test results can be positive, negative or inconclusive, and interpretation by a certified genetic counselor is strongly recommended.
Topics that should be reviewed in a genetic counseling session about ovarian cancer:
- Personal history of cancer
- Family history of cancer
- Risks, benefits and limitations of genetic testing
- Costs and insurance coverage for genetic testing
- BRCA1 and BRCA2 genes
- The correlation between having a mutation in these genes and risk for ovarian and breast cancer
- If genetic testing should be done and if so, who the best person is to begin testing (usually the person that has ovarian cancer)
- Reviewing the possible results of genetic tests and what each result would mean
- How results would impact other family members
People who do not have ovarian cancer themselves should consider getting genetic counseling if they have a significant family history of ovarian cancer. Any of the following is considered sufficient to warrant genetic counseling for hereditary breast/ovarian cancer:
- Both ovarian and breast cancer on one side of the family
- Ovarian, breast and pancreatic cancer on one side of the family or in one individual
- Multiple cases of breast cancer
- Breast cancer diagnosed prior to age 45
- Male breast cancer
- Jewish ancestry
Photo by Jason Devaun, via Flickr