Ovarian cancer: Identifying and managing high-risk patients

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October 2004 · Vol. 16, No. 10

Ovarian cancer: Identifying and managing high-risk patients

Two cases illustrate when to refer for genetic counseling and what to advise women concerned about prevention.

Michael G. Muto, MD

Codirector, Familial Ovarian Cancer Center, Gillette Center for Women’s Cancers, Dana-Farber Cancer Institute, Boston.

KEY POINTS

Ask every patient: ”Has anyone in your family had breast cancer under the age of 35, or colorectal, uterine, or ovarian cancer?
Genetic testing is appropriate only when pre- and post-test counseling is available, the test can be interpreted, and the results will help in medical and surgical management.
Oral contraceptives may reduce risk by 10% per year for up to 5 to 7 years of use.
Bilateral salpingo-oophorectomy in BRCA carriers reduces the risk of ovarian cancer by more than 90% and the risk of breast cancer by more than 50%.

CASE 1

A 42-year-old woman of Ashkenazi Jewish ancestry, whose mother had a diagnosis of ovarian cancer a year earlier, is worried that she may also be at risk.

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