If you have a history of ovarian cancer, learn about the potential benefits of breast cancer screening. Stay informed with expert advice from Meri Sehat.

I Have A History Of Ovarian Cancer, Should I Undergo Screening For Breast Cancer?

If you have a history of ovarian cancer, you may be wondering whether you should undergo screening for breast cancer. The link between ovarian cancer and breast cancer is a topic of concern for many individuals, especially those with a family history of ovarian cancer.

Introduction

Understanding the link of ovarian cancer and breast cancer

While the ovaries and breasts may be far apart in the human body, they are connected through a genetic component. The BRCA1 and BRCA2 gene mutations are believed to play a role in causing both breast and ovarian cancer. Inherited mutations in these genes account for 3% of breast and 10% of ovarian cancers<a href="#accordion">[1]</a>. However, mutations in other genes can also predispose one to developing ovarian or breast cancer. Therefore, women with a personal history of ovarian cancer due to an inherited mutation are at an increased risk of developing breast cancer. 
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Family history plays a crucial role in determining breast cancer risk, particularly when ovarian cancer is involved. Women with a first-degree relative (mother, sister, or daughter) diagnosed with ovarian cancer may experience a higher-than-average risk of breast cancer. As per a Swedish study, women with a family history of ovarian cancer have a 1.25-fold increased risk of developing breast cancer<a href="#accordion">[2]</a>. The underlying factors contributing to this link are not entirely clear, but it is believed that shared genetic mutations (e.g., BRCA1 and BRCA2 genes) and hormonal influences could play pivotal roles. 
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Breast cancer is the most prevalent cancer worldwide, accounting for more than 2 million cases in 2020<a href="#accordion">[3]</a>. According to the American Cancer Society, women in the general population have about a 13% chance of developing breast cancer in their lifetime<a href="#accordion">[4]</a>. However, for those with a family history of ovarian cancer, the risk can be substantially higher. For instance, women with a BRCA1 mutation face up to a 72% risk of developing breast cancer, while those with a BRCA2 mutation have a 69% risk by the age of 80<a href="#accordion">[5]</a>. Additionally, the risk of breast cancer may increase further if the ovarian cancer diagnosis occurred before the age of 50. 
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Screening programs help detect breast cancer and reduce associated morbidity and mortality. Given the increased risk associated with a history of ovarian cancer and family history, early detection becomes critical. The following are the screening recommendations for high-risk individuals<a href="#accordion">[6]</a>: 
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<ul>
	<li>Mammography - The American Cancer Society recommends that women with an average risk of breast cancer commence yearly mammograms at age 45. However, for those with a family history of ovarian cancer, earlier initiation of mammograms is advised. Typically, screenings should begin 10 years earlier than the age of the youngest affected relative, but not before age 30. 
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	<li>Breast Magnetic Resonance Imaging (MRI) - For high-risk individuals, breast MRI is an essential complement to mammography. It is more sensitive in detecting breast cancer, especially in dense breast tissue. The ACS recommends that women with a 20-25% or greater lifetime risk of breast cancer should consider adding breast MRI to their screening regimen, usually starting at age 30<a href="#accordion">[7]</a>. 
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	<li>Clinical Breast Exams - Regular clinical breast exams by a healthcare professional should be conducted every 6-12 months. This physical examination can help detect any suspicious changes in the breast. 
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	<li>Genetic Counseling And Testing - If a family history of ovarian cancer is present, especially in conjunction with breast cancer, genetic counseling, and testing may be beneficial to identify specific genetic mutations that increase the risk. Knowledge of these mutations can inform personalized screening and risk-reducing strategies. 
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</ul>

Conclusion

For individuals with a history of ovarian cancer or a strong family history of the disease, being proactive about breast cancer screening is crucial. The link between ovarian and breast cancer underscores the importance of early detection. High-risk individuals can significantly improve the chances of detecting breast cancer at its earliest, most treatable stages by following the recommended screening guidelines, which may include earlier and more frequent mammograms, breast MRIs, and regular clinical exams. Moreover, considering genetic counseling and testing can provide valuable insights to aid in tailored risk management strategies. 
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If you have a personal or family history of ovarian cancer, get in touch with a healthcare professional who can help assess your risk of developing breast cancer in the future and determine the best course of action for you.

Remember, a family history of breast or ovarian cancer, or possessing a gene mutation does not guarantee that you will develop breast cancer. Nor does its absence mean you will not develop breast cancer later on. Therefore, it&rsquo;s important to stay vigilant by performing self-breast exams and undergoing mammograms in accordance with the medical recommendations. 
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[1] BRCA1 and BRCA2. Centers for Disease Control and Prevention.

[2] Mukama T, Kharazmi E, Sundquist K, Sundquist J, Fallah M. Risk‐adapted starting age of breast cancer screening in women with a family history of ovarian or other cancers: A nationwide cohort study. Cancer. 2021;127(12):2091-2098. doi:10.1002/cncr.33456

[3] Breast Cancer. World Health Organization.

[4] Key Statistics for Breast Cancer. American Cancer Society.

[5] Kotsopoulos J. BRCA Mutations and Breast Cancer Prevention. Cancers (Basel). 2018;10(12):524. Published 2018 Dec 19. doi:10.3390/cancers10120524

[6] American Cancer Society Recommendations for the Early Detection of Breast Cancer. American Cancer Society.

[7] Saslow D, Boetes C, Burke W, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography [published correction appears in CA Cancer J Clin. 2007 May-Jun;57(3):185]. CA Cancer J Clin. 2007;57(2):75-89. doi:10.3322/canjclin.57.2.75

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