Breast Cancer and Ovarian Cancer: What Is the Relationship?
Medically reviewed by Doru Paul, MDMedically reviewed by Doru Paul, MD
Breast cancer and ovarian cancer can be linked for several reasons. Hormonal factors can be at play in both cancers, and there are also several gene mutations, most notably BRCA1 and BRCA2, that increase the risk of both cancers.
Knowing more about each of these cancers and how they are related can help you talk with a healthcare provider about your risk. This article will explore the connection between breast cancer and ovarian cancer, the risk of developing each cancer, and the treatment, management, and prevention of these cancers.
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Connection Between Breast and Ovarian Cancer
Breast cancer and ovarian cancer may be connected through several aspects, including hormonal factors as well as genetics.
Hormonal Factors
There are different kinds of breast cancer, and many are hormone-responsive. If a breast cancer is hormone receptor-positive, the hormone estrogen helps fuel the cancer. The ovaries produce this hormone.
People who have hormone receptor-positive breast cancer may either go on anti-estrogen medication (hormonal therapy) or choose to have their ovaries removed to stop feeding the growth of the cancer.
Genetic Factors
The most common genes that increase the risk of breast cancer (as well as ovarian cancer) are the BRCA1 and BRCA2 genes. Advances in gene analysis have found other genes that may increase the risk of both cancers, including these genes:
CHEK2
ATM
PALB2
TP53
PTEN
Risks
Though having breast and ovarian cancer at the same time is uncommon, having one increases the risk of developing the other, especially for people with genetic mutations.
A 2020 study found that people who had breast cancer had a higher risk of a second primary cancer diagnosis than the general population. The study also found people diagnosed with ovarian cancer were more likely to be diagnosed with primary breast cancer later.
Though BRCA mutations accounted for some of this, it’s also likely that things like environmental or hormonal factors were among the causes. In the study, of those who were first diagnosed with ovarian cancer, 65.6% were diagnosed with breast cancer within five years; of those first diagnosed with breast cancer, 41.5% were later diagnosed with ovarian cancer.
People diagnosed with breast or ovarian cancer should be monitored and screened for the other cancer for the rest of their lives and for a recurrence of the original cancer. This is regardless of whether they have a genetic mutation that increases their risk of these cancers. Preventative measures should also be reviewed.
Treatment and Management of Breast Cancer With Ovarian Cancer
Getting diagnosed with both breast and ovarian cancer at the same time is uncommon. If you are diagnosed with either cancer, your healthcare provider will likely go over your increased risk of the other cancer, possibly recommend genetic testing to see if you are at significantly increased risk, and plan treatment accordingly.
Breast cancer is treated in a variety of ways, depending on the stage of the cancer, your age, your overall health, and characteristics of your specific cancer, such as hormone receptor status. Typically, treatment includes more than one kind of treatment. Treatments can include:
Chemotherapy: Use of drugs that kill actively dividing cells
Radiation therapy: Use of radiation to kill cancer cells
Hormone therapy: Use of drugs that block the production or effects of hormones that can stimulate the growth of the cancer
Targeted drug therapy: Use of drugs that target specific characteristics of the tumor cells, including Lynparza (olaparib) and Talzenna (talazoparib) for people with BRCA1 or BRCA2 mutations
Treatment for ovarian cancer depends on the stage of the cancer, the type of ovarian cancer, and your general health. Ovarian cancer is typically treated with a combination of surgery and chemotherapy. Other therapies can include:
Radiation therapy
Hormone therapy
Targeted drug therapy
If you have been diagnosed with either breast or ovarian cancer, it’s important to be monitored for the other cancer as well, especially if you are known to have a genetic mutation that increases your risk of developing either cancer.
Prevention
Though it may not be completely possible to prevent both cancers, there are things you can do to reduce your risk of developing them or detect them at an early stage.
Screenings
Regular mammograms help find breast cancer early. For average-risk women, routine mammograms are recommended starting at age 40. If you have a genetic mutation that increases your risk of breast or ovarian cancer, you may need to start the screenings earlier.
For someone who has had ovarian cancer, you may have regular CA-125 blood tests to monitor the number. This protein is often elevated in people with advanced ovarian cancer, and in some people with early ovarian cancer.
CA-125 is not a screening tool for ovarian cancer because the number can fluctuate for a variety of reasons. It misses half of all early ovarian cancers. The National Cancer Institute and U.S. Preventative Services Task Force don’t endorse it as a screening tool for the general population or for those without increased risk.
If you are at an increased risk for these cancers, talk with your healthcare provider to find out which screening tests they recommend and when to start.
Prophylactic Surgery
To help prevent breast and/or ovarian cancer, some people with genetic mutations that increase their risk opt to have prophylactic (preventative) surgeries. Prophylactic mastectomy (breast removal) reduces breast cancer risk by 90% in females with a BRCA1 or BRCA2 mutation.
Prophylactic salpingo-oophorectomy (removal of the ovaries and fallopian tubes) reduces the risk of ovarian or fallopian tube cancer by 85% to 90% and breast cancer by 40% to 70% in people with BRCA1 or BRCA2 mutations.
There are many things to consider, however, with prophylactic surgery, including pain, recovery time, whether insurance will cover it, general surgery risks, and subsequent quality of life.
Removing the ovaries immediately puts a person into menopause, which may have significant emotional and physical side effects, including increasing the risk of conditions such as osteoporosis (progressive bone loss) and cardiovascular disease if not followed by hormone therapy.
Lifestyle Factors
Living a healthy lifestyle can help reduce your risk of developing cancer, although it is still possible to live a healthy life and get cancer. Things you can do to help reduce your risk can include:
Maintaining a healthy weight
Engaging in physical activity
Minimizing or abstaining from drinking alcohol or smoking cigarettes
Breastfeeding your children, if possible
Each person is different, so it’s also important to speak with a healthcare provider about your family history, risk factors, and what you can do to help keep yourself as healthy as possible.
Summary
Breast cancer and ovarian cancer are linked in a variety of ways, including (but not limited to) genetic mutations that increase the risk of both cancers. If you are diagnosed with one of these cancers, it increases your risk of developing the other.
Your treatment plan will likely include monitoring for the other cancer, genetic testing, and possibly a discussion of any preventative measures like surgery, if appropriate.
A Word From Verywell
If you are interested in genetic testing for genes related to breast and ovarian cancers, talk with a healthcare provider. Even though you can take at-home genetic tests, testing in a lab can ensure a level of accuracy that an at-home kit cannot.
A positive result from an at-home kit will also need a lab to confirm it, and even if it’s negative, that doesn’t mean the result is correct or that you don’t have a different genetic mutation for which the kit did not test.
Genetic testing through a lab will also ensure that you will meet with a genetic counselor. They will go over your risk, what a positive or negative result means, and any further testing or monitoring you may need.
Read the original article on Verywell Health.
