Ovarian Cancer Screening

When a woman is diagnosed with cancer, she needs to consider her family’s history of cancer. Some cancers are inherited; however, most are spontaneous. If there is a concern with a family pattern of cancer, then a thorough family history should be taken. Sometimes this leads to formal genetic counseling with blood testing for specific gene mutations. If you have a specific gene mutation putting you at risk for breast or ovarian cancer, then surveillance testing or procedures are different from those with a spontaneous cancer. Therefore, start with telling your oncologist your family history. I'm not sure what is standard, but my gynecologist is going to give me internal ultrasounds to check my ovaries yearly until I'm 40 years old. Then when I turn 40, the plan right now is to have my ovaries removed. Unless anything funny looks like it's going on, then they get pulled then. I should note I'm 32 right now, so that may change.
My breast specialist thought this plan was fine so we're running with it.

When the survivor has a deleterious mutation of the BRCA 1 or 2 gene that carries an elevated risk, or if ovarian cancer runs in the family. When the survivor has a deleterious mutation of the BRCA 1 or 2 gene that carries an elevated risk, or if ovarian cancer runs in the family.

In patients with the BRCA gene, ovarian cancer can occur in addition to breast cancer. The risk depends on which BRCA gene mutation they inherited, with BRCA 1 patients having a risk of ovarian cancer as high as 44% and BRCA 2 patients having a risk as high as 27%. For patients without the BRCA gene, the risk is much lower. Breast cancer can metastasize to the ovary, causing tumors called Krukenberg tumors. Years ago, before the advent of medications to suppress estrogen formation by the ovary, many oncologists requested that the ovaries be removed to reduce estrogen in premenopausal breast cancer patients. That is not really done anymore except in extenuating circumstances. At the moment, there is no specific protocol to monitor the ovaries of breast cancer survivors. Some gynecologists will not change their standard care and others will offer sonograms (ultrasounds) both to assess the uterine lining in patients taking Tamoxifen and to look at the ovaries. Sadly, as mentioned in other questions on this site, ovarian cancer can be sneaky and not show up on scans. My thought is to not worry too much unless you are BRCA positive. Please ask your doctor if you qualify for testing. In patients with the BRCA gene, ovarian cancer can occur in addition to breast cancer. The risk depends on which BRCA gene mutation they inherited, with BRCA 1 patients having a risk of ovarian cancer as high as 44% and BRCA 2 patients having a risk as high as 27%. For patients without the BRCA gene, the risk is much lower. Breast cancer can metastasize to the ovary, causing tumors called Krukenberg tumors. Years ago, before the advent of medications to suppress estrogen formation by the ovary, many oncologists requested that the ovaries be removed to reduce estrogen in premenopausal breast cancer patients. That is not really done anymore except in extenuating circumstances. At the moment, there is no specific protocol to monitor the ovaries of breast cancer survivors. Some gynecologists will not change their standard care and others will offer sonograms (ultrasounds) both to assess the uterine lining in patients taking Tamoxifen and to look at the ovaries. Sadly, as mentioned in other questions on this site, ovarian cancer can be sneaky and not show up on scans. My thought is to not worry too much unless you are BRCA positive. Please ask your doctor if you qualify for testing.