Breast-cancer gene mutation also raises risk for uterine cancer

Women who have the BRCA1+ gene mutation might also be at elevated risk not just for breast cancer, but for uterine cancer too, according to a new study published in the Journal of the American Medical Association Oncology.

More than 1,000 American and British patients with the BRCA1 and BRCA2 mutations who underwent risk-reducing salpingo-oophorectomy (RRSO) between 1995 and 2011 were studied to see if a higher incidence of uterine cancer showed up in either cohort and whether a hysterectomy might then make sense for patients with similar characteristics in the future as an additional, preventative treatment.

The researchers did not note an overall higher risk for uterine cancer in the women in the study. But women who had the BRCA1 gene did show a higher rate of serous or serous-like endometrial carcinoma, even after they underwent the RRSO.

Overall, researchers would have expected to see about four of these nearly 1,100 women develop a uterine cancer in the seven to 12 years after their RRSO. In reality, they observed eight women develop a uterine cancer, with the highest expected-to-observed ratio (22.2) in the BRCA1 group—four of the five endometrial carcinomas observed were found in that group.

Based on the expected-to-observed ratio info, the researchers established a risk percentage of BRCA1+ women who have had RRSO at age 45 developing serous/serous-like carcinoma by age 70. They found those women were 2.6 percent likelier than other women to develop such a cancer, assuming a constant annual risk, and 4.7 percent likelier, assuming a constant relative risk.

These findings could change treatment plans for certain women with certain risk factors, according to the study. Since overall uterine cancer risk increase was not observed, some doctors and their patients might choose to forego a hysterectomy at the same time as the RRSO, which as the study points out has already been a controversial option. Other women with the BRCA1 gene who also have other risk factors might choose a concurrent hysterectomy with an RRSO.