ABSTRACT
While risk of breast cancer forBRCA carriers is extremely high, risk of ovarian cancer is still significant. In general, the lifetime risk of ovarian cancer is 1 in 70; however, for BRCA1 carriers, the risk is as high as 39% to 46% (1), and forBRCA2 carriers, it is 12% to 22% (2,3). About 5% to 10% of ovarian cancers are due to inherited risk, and 90% of those are due to
BRCA1 or BRCA2 mutations. Often, the first sign of a BRCA mutation (referring to either gene) in the family is multiple breast and ovarian cancers amongst close blood relatives.
Following identification of these two genes (4,5) in the mid-1990s, genetic tests were
developed that could identify carriers of BRCA mutations. The question then arises: What clinical interventions are advisable for reducing the risks of ovarian cancer following
identification of a patient at higher risk than normal, either due tomultiple familial breast or
ovarian cancers or due to the presence of a BRCAmutation within the family? This chapter reviews the research, as of early 2007, for two approaches aimed at reducing the risk of
ovarian cancer, namely prevention strategies and screening for early detection of ovarian
cancer. However, it should be indicated at the outset that for women carrying a deleterious
BRCA mutation, the current standard intervention is surgical removal of the ovaries following completion of child bearing. This standard is due to the high mortality from the
late stage of diagnosis formost (75%) (6) ovarian cancers. Surgical removal of the ovaries is
the most effective strategy for reducing mortality due to ovarian cancer (7).
