OVARIAN CANCER AND GENE MUTATIONS
Dr Steven R. Goldstein is a leading obgyn in Manhattan who screens patients for ovarian and cervical cancer. Today, women are making decisions to remove their ovaries based on their gene findings. BRCA1 and BRCA2 are tumor suppressor genes, which means that they keep cells from growing too rapidly. Everyone has these genes. Changes or mutations in these genes mean they do not work properly and cells can grow out of control, which can lead to cancer. According to the American College of Obstetricians and Gynecologists (ACOG), the estimated risk of ovarian cancer in women with a BRCA1 mutation is 39 to 46 percent by age 70. For women with a BRCA2 mutation, the risk of ovarian cancer by age 70 is 10 to 27 percent. The BRCA1 tends to cause high grade ovarian tumors and be pre-menopausal. The BRCA2 gene is less likely to be high grade and more likely to occur post-menopausal. In addition, less than 10% of ovarian cancers are related to this genetic mutation. Still, ovarian cancer tends to be a very lethal disease. In the “real world”, 82% of ovarian cancer presents as stage III or IV. The University of Kentucky ovarian cancerscreening program however found just the opposite. By annual transvaginal ultrasound screening, they picked up 82% of ovarian tumors at stage I or II, which is the exact opposite of the rest of the population. Recently a screening program in Britain, also using annual ultrasound screening,