The link between ovarian cancer and breast cancer

The main connection between ovarian cancer and breast cancer is an inherited genetic link, primarily through mutations in the BRCA genes. People who have inherited BRCA gene faults have a significantly increased risk of developing both diseases. A personal or family history of one cancer often prompts genetic testing and screening for the other.

This page will cover:

• The BRCA gene fault
• Other genetic mutations
• Family history and hereditary risk
• Age and lifestyle risk factors
• Are you more likely to get breast cancer if you’ve had ovarian cancer?
• Is it common to have breast cancer and ovarian cancer at the same time?
• Shared symptoms to look out for
• Should someone with breast cancer get checked for ovarian cancer
• Preventive surgeries to reduce ovarian and breast cancer risk
• Monitoring cancer risk after breast cancer or ovarian cancer
• Finding support groups
• FAQ's
  

A genetic fault, sometimes called a mutation or alteration, is like a spelling mistake in your body’s instruction manual. It changes how things work and can raise your risk of developing cancer.

The BRCA Gene fault

Everyone has BRCA genes, which we inherit from our parents. These genes help repair damaged cells and stop them from growing too quickly.

Inherited gene changes such as the BRCA gene fault don’t cause the majority of breast and ovarian cancer cases. In the general population, about 1 in 200 people carry a BRCA1 or BRCA2 mutation. However, this number is much higher in certain groups – for example, around 1 in 40 people with Ashkenazi Jewish heritage have one of these mutations.

Other genetic mutations

Lynch syndrome is a condition that increases the chance of developing certain cancers, including bowel, ovarian, and womb cancer. It happens because of changes in genes such as MLH1, MSH2, MSH6, PMS2, and EPCAM. Normally, these genes help protect the body by repairing DNA and stopping cancer from forming. When they don’t work properly, your risk of cancer increases.

There are a small amount of other genes which have been connected to ovarian cancer. Some of these genes are at moderate risk, and none are thought to increase ovarian cancer risk as much as BRCA1 does. Mutations in these genes are found less often than those in BRCA1 and BRCA2. These genes are: 

• RAD51C 
• RAD51D 
• BRIP1 
• PALB2 

There are also some other genes that are linked to specific types of ovarian cancer seen in very rare cancer syndromes. These genes are:

• STK11 (Peutz-Jeghers syndrome) which is linked to sex cord (SCTAT) tumours
• DICER1 which is linked to Sertoli-Leydig cell tumours

Family history and hereditary risk

Family history can play a significant role in your risk of developing breast or ovarian cancer. This is often due to inherited faults in certain genes, like BRCA1 and BRCA2, which help repair damaged cells. When these genes don’t work properly, your cancer risk increases. Having a family history of cancer doesn’t mean you will definitely get cancer, but it’s important to talk to your doctor about your risk and whether genetic testing or extra screening could help.

Age and lifestyle risk factors

The risk of ovarian cancer and breast cancer both increase as you get older. Ovarian cancer has a strong association with age. Currently around 84% of ovarian cancer cases diagnosed are in women who are 50 or older, and over half of all cases diagnosed in women are aged over 65. However It is still important to remember that women can get ovarian cancer at any age, so it is important to always be symptom aware.

Are you more likely to get breast cancer if you’ve had ovarian cancer?

Not usually. However, if you have a BRCA gene change, another inherited gene fault, or Lynch syndrome, your risk of developing breast or ovarian cancer is higher than average.

Is it common to have breast cancer and ovarian cancer at the same time?

Having breast and ovarian cancer at the same time is uncommon, but it can happen. This is more likely for people with inherited conditions such as a BRCA gene mutation, which increases the risk of both cancers.

Shared symptoms to look out for:

Whilst ovarian cancer don't typically share the same symtoms due to their location - there are some symptoms you should look out for. Any persistent pain in your breasts or ovaries can be a sign of something amiss. However, for breast cancer the main signs are:

• A new lump or thickening in the breast or armpit,
• Changes in the skin such as dimpling or redness
• Changes to the nipple, such as it turning inward or nipple discharge

The four main symptoms of ovarian cancer are:

• Tummy pain
• Persistent bloating
• Feeling full
• Needing to pee more frequently

Should someone with breast cancer get checked for ovarian cancer

If you are worried your cancer may be caused by genetic factors - you should discuss this with your GP. If you test positive for gene faults such as Lynch Syndrome or BRCA 1/2 you might opt for preventative surgery such as a hysterectomy or a mastectomy.

Preventative surgeries to reduce ovarian and breast cancer risk

For breast cancer, people may choose to opt for a surgery called a bilateral mastectomy for risk reduction. This involves removing most of the healthy breast tissue from both breasts.

Having both breasts removed can reduce the likelihood of breast cancer by around 95%. While almost all breast tissue is taken away, it’s not possible to remove every cell. A tiny amount remains, which means there is still a very small risk of cancer developing.

You may choose to have breast reconstruction at the same time. Some people opt for this and some decide not to.

If your family history suggests a high likelihood of developing breast or ovarian cancer, you might want to explore surgery to remove your ovaries and fallopian tubes. Understanding the facts can help you make an informed choice about whether this procedure is right for you.

This type of surgery is usually recommended for women with a lifetime ovarian cancer risk of more than 20%.

Monitoring cancer risk after breast cancer or ovarian cancer

In the first few years after a diagnosis, follow-up appointments are usually more frequent. The exact schedule depends on where you’re receiving treatment, but they often take place every three months.

If you’re on maintenance treatments such as PARP inhibitors or bevacizumab, you’ll need regular blood tests to check for side effects, these appointments are usually:

• PARP inhibitors: blood tests once a month
• Bevacizumab: blood tests, blood pressure checks, and a urine test every three weeks

These tests help your team monitor how the treatment is working and confirm it’s safe to continue with the next cycle.

Once maintenance treatment ends, follow-up will still continue, but the time between appointments may change. Your healthcare team will explain what to expect going forward. This can vary across the UK, so try not to compare your schedule with others.

During follow-up, your team may use a range of tests to monitor your progress. These can include blood tests (such as a CA125 test), physical examinations, CT scans and other imaging.

If you’re taking part in a clinical trial or receiving maintenance treatment, you’ll have regular blood tests to check for side effects. You may also have your blood pressure monitored and provide a urine (wee) sample for testing.

Support groups

You can find our list of support groups here: https://ovarian.org.uk/hereditary-cancer-and-risk/where-can-i-find-support/ they are sorted by area and support type needed.

FAQ's