ICARE Newsletter Summer 2017

Ask the Expert

The following question was addressed by Dr. Steven Narod who is a Tier I Canada Research Chair in Breast Cancer and a senior scientist at the Women’s College Research Institute in Toronto, Canada. Dr. Narod is a world-leader in the field of breast and ovarian cancer genetics.

Q. In women with a BRCA mutation and ovarian cancer, who might benefit the most from MRI screening or mastectomy?

A. Although risk-reducing mastectomy (RRM) and MRI screening are routinely offered to unaffected BRCA carriers, there are limited studies to guide whether those with a history of ovarian cancer would also benefit from RRM or MRI screening. We recently studied this question among 509 BRCA carriers with ovarian cancer through our registry database.1 We found that twenty (3.9%) patients developed breast cancer within the 10 years following their ovarian cancer diagnosis. Through simulation results, we were able to show limited benefit from MRI screening or RRM among most patients. However, our data suggests that women who had already survived 10 years or more following ovarian cancer or those with early stage ovarian cancer (stage I or II) could benefit from MRI or RRM. Based on these findings, we suggest that BRCA carriers with an ovarian cancer diagnosis and no prior history of breast cancer may benefit from MRI or RRM when they are 10 years out from their ovarian cancer diagnosis without a recurrence, or if they were diagnosed with early stage ovarian cancer.