New research shows mutations in BRCA1 or BRCA2 may increase risk for endometrial cancer

A Dutch study added further evidence that women with a BRCA1 mutation may have an elevated risk for endometrial cancer. The study found that endometrial cancer in women with either a BRCA1 or BRCA2 mutation was more likely to be an aggressive form of cancer associated with poor outcomes.

Women with a BRCA1 or BRCA2 mutation who are considering risk-reducing salpingo-oophorectomy (RRSO) to remove their ovaries and fallopian tubes may also want to consider hysterectomy (removal of the uterus) at the same time. For women with a uterus, estrogen plus progesterone hormone therapy is recommended after risk-reducing removal of the ovaries and fallopian tubes. For pre-menopausal women, hormone replacement therapy has not been shown to increase the risk of breast cancer. However, there may be some risk for post-menopausal women. Removing the uterus allows for simplified hormone replacement therapy with estrogen alone, to avoid the potential risk of breast cancer.

Although the lifetime risk for endometrial cancer is very low among individuals with BRCAmutations, some women whose risk is high due to personal risk factors or a family history of endometrial cancer may choose to have a risk-reducing hysterectomy.

Current guidelines in the United States recommend that women with an inherited BRCA mutation speak with their healthcare provider about the benefits and risks of hysterectomy at the time of risk-reducing salpingo-oophorectomy (removal of the ovaries and fallopian tubes).

If you have a BRCA mutation and you have had risk-reducing salpingo-oophorectomy but kept your uterus, you may still have an increased risk for endometrial cancer. Currently, experts do not recommend hysterectomy to reduce endometrial cancer risk for women who did not remove their uterus at the time of their RRSO.

The most common sign of endometrial cancer is abnormal vaginal bleeding. Women who have additional risks, symptoms, or concerns about endometrial cancer should speak with their surgeon about the benefits and risks of hysterectomy.

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