BRCA Mutations and Non-Breast Cancer Risk

While bilateral mastectomy and oopherectomy dramatically reduce the future risk of breast cancer and ovarian cancer in in women who carry BRCA-1 or BRCA-2 gene mutations, the risk of future cancers in such women may not decrease to the same level as the general population.

For example, even after these radical surgical approaches to cancer risk reduction, the risk of primary peritoneal cancer remains higher in women with BRCA gene mutations than for the general population. Additionally, there is some available public health data suggesting a mildly elevated risk of cancers of the prostate, stomach, pancreas, and liver in families with early-onset breast cancers (many of which are likely related to BRCA gene mutations). Fortunately, the "absolute" increased risk of developing these non-breast cancers is actually quite small.

Based upon these considerations, women with confirmed BRCA gene mutations should be monitored for non-breast cancers, as well as for breast cancer arising in microscopic breast cells left behind following mastectomy. (Unfortunately, however, beyond currently accepted screening exams for breast cancer, colorectal cancer, and cervical cancer, there are no universally established standards for more intensive screening programs for non-breast cancers in BRCA-positive women, at this time.)

Thank you for that detailed clarification.

Should a BRCA patient in this circumstance need a specialist (gyn onc, breast surgeon, and/or other such specialist) for her regular surveillance? I was told by several doctors that I am no longer in any risk group and therefore can stop mammograms, breast MRI and pelvic ultra sounds. Basically, they say/said, I have reduced my risk to that of the general population (and possibly lower). I was told this by a gyn onc at a highly respected cancer center in Philadelphia and a breast surgeon at another highly respected cancer center in another area of PA. Should I keep looking for a doctor who will offer me these screenings? (I have very good insurance, so I'm certain this was not the consideration)

Also - Is there an increased risk of colon cancer?

Thank you for providing this resource and for taking the time to answer.