Dr. Shana Wingo, a board-certified gynecologic oncologist with Banner Thunderbird Medical Center in Glendale, Arizona, explains that approximately 10 percent of ovarian cancers are hereditary, with 90 percent being random.
"A woman's baseline risk for ovarian cancer is one in 70, or 1.7 percent. With one first-degree relative [with ovarian cancer], this risk increases to 4 percent, and with two first-degree relatives, this increases to 7 percent," Dr. Wingo explains.
So statistically speaking, if a woman has ovarian cancer, it is much less likely to be from a genetic cause.
"That being said, if women have a family history of ovarian, fallopian tube or primary peritoneal carcinoma, it is best if the affected family member receives genetic testing," the doctor recommends.
The National Comprehensive Cancer Network (NCCN) guidelines recommend that all women who are affected with one of these cancers be offered testing for BRCA1 and BRCA2 (breast cancer genes 1 and 2). The Susan G. Komen Foundation reports that women who carry these inherited gene mutations have a greatly increased risk of breast cancer and ovarian cancer.
Angelina Jolie made a brave decision to have a preventive double-mastectomy and to reportedly have her ovaries removed (prophylactic oophorectomy) because of her family history (her mother died of ovarian cancer at age 56 and her maternal aunt died of breast cancer at 61). Since then, Wingo says, she has seen an uptick in her medical practice of women requesting genetic testing.
"Many gynecologic oncologists encourage our patients to undergo testing," Wingo says. "Angelina Jolie bringing [her] private struggles to a public forum has greatly increased awareness. Not everyone should be tested, but it allows us to provide more education, and refer the appropriate individuals for testing."
The Mayo Clinic reports that high-risk women age 35 and older, who have a strong family history of breast and ovarian cancer and who have completed childbearing, are the best candidates for surgical ovary removal. This decreases the risk of ovarian cancer by 80 to 90 percent.
The risks related to having your ovaries removed are bone-thinning (osteoporosis), menopause symptoms (hot flashes, vaginal dryness, sleep disturbances), increased risk of heart disease and the lingering risk of primary peritoneal cancer.
"Ovarian cancer is not the most common gynecological cancer we treat, but it is the most lethal," Wingo concludes. "As more awareness is brought forward, people realize they are not in a vacuum. More people are asking questions, and the information you get can impact your and your family’s future."
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