Women’s Health

CATEGORY: WOMEN’S HEALTH

Women who carry a faulty BRCA1 or BRCA2 gene face high lifetime risks of both breast and ovarian cancer. A large 2025 study of about 3,400 such women who had already had breast cancer found that those who had their ovaries and fallopian tubes surgically removed were roughly half as likely to die over the follow-up period — and, reassuringly, gained that benefit without the rise in heart disease that many women fear from early surgical menopause.¹

What BRCA Genes Mean

BRCA1 and BRCA2 are genes that normally help repair damaged DNA. When someone inherits a faulty (“pathogenic”) version, that protection is weakened, sharply raising the odds of breast and ovarian cancers. Because ovarian cancer is hard to detect early, women with these variants are often advised to consider having the ovaries and fallopian tubes removed once childbearing is complete — a procedure called bilateral salpingo-oophorectomy.

What the Study Found

Researchers at the University of Cambridge linked NHS health records for 1,674 BRCA1 and 1,740 BRCA2 carriers who had been diagnosed with breast cancer. Women who underwent the surgery had a 48% lower risk of death from any cause (hazard ratio 0.52). The benefit extended to dying specifically from breast cancer, with risk cut by 38% in BRCA1 carriers and 52% in BRCA2 carriers. In plain terms, removing the ovaries was associated with meaningfully better survival in women already dealing with breast cancer.¹

The Reassuring Part About Heart Health

Removing the ovaries before natural menopause causes an abrupt drop in estrogen, and a long-standing worry is that this might raise the risk of heart disease later. In this study, it did not: the surgery was not linked to any increase in cardiovascular disease (hazard ratio 0.73, a result statistically consistent with no added risk), ischemic heart disease, non-cancer death, or depression. That absence of harm is part of what makes the survival finding so meaningful for decision-making.

How to Read This Finding

This was an observational study — it tracked women’s real-world choices rather than randomly assigning surgery — so it shows a strong association rather than absolute proof. It also applies specifically to women who carry a BRCA1 or BRCA2 variant and have had breast cancer, not to women at average risk, for whom removing healthy ovaries is not recommended. The value here is in giving carriers and their doctors solid numbers to weigh.

Key Takeaways

• If you carry a BRCA1 or BRCA2 variant and have had breast cancer, this study links removing the ovaries and fallopian tubes to about half the risk of death — strong information to discuss with your care team.
• The survival benefit came without an increase in heart disease, addressing a common concern about early surgical menopause.
• This applies to BRCA carriers specifically; removing healthy ovaries is not advised for women at average risk.
• Decisions about genetic testing and risk-reducing surgery are highly personal — discuss timing, benefits, and menopause management with a specialist or genetic counselor.

References

1. Hassan H, Allen I, Rahman T, et al. Long-term health outcomes of bilateral salpingo-oophorectomy in BRCA1 and BRCA2 pathogenic variant carriers with personal history of breast cancer: a retrospective cohort study using linked electronic health records. Lancet Oncol. 2025 Jun;26(6):771-780. link

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