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Knowing Your Risk for Ovarian & Breast Cancer

Scott Weissman September 20, 2011 1:00 PM This chat has ended. Thank you for participating.
Catherine (Moderator) - 12:50 PM:
Welcome! Today’s chat: Knowing Your Risk for Ovarian & Breast Cancer will begin shortly. Please start submitting your questions and Scott Weissman will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Kellogg Cancer Center to obtain more information about ovarian and breast cancer. We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.

Tyra (Chicago, IL) - 1:01 PM:
Hi Mr. Weissman. I have a question for you. I have been diagnosed by my ob/gyn that I have hemorrhagic cyst, and I wanted to know is there anything to prevent them.

Scott Weissman (NorthShore):
Hi Tyra- That is a very good question, but that information is a little bit out of my scope of knowledge. I would suggest following up with your ob/gyn and pose that question to him or her directly. Thank you for the question.

Mary (Chicago, IL) - 1:03 PM:
My mother has had both ovarian and breast cancer, my maternal and paternal grandmothers both died of ovarian cancer. I have yearly transvaginal ultrasounds as well as CA-125 markers. I am 54 years old and have been post menopausal for 14 years. I want to go ahead and electively have a hysterectomy, do you think this is a good decision? My gynecologist (who treated my mother) remains somewhat hesitant.

Scott Weissman (NorthShore):
Mary- I think that opting for hysterectomy is certainly a reasonable option given the family history you are reporting. Based on your family history, you meet national guidelines to consider genetic testing for the BRCA genes to better assess your risk of breast and ovarian cancer. Not only may this help solidfy your decision for surgery, but it will also help determine if you should be undergoing increased breast cancer screening as well. Thank you for the question.

Katie (Chicago, IL) - 1:06 PM:
I have a strong family history of breast cancer (mom, aunt, and grandma have all had it). When is the best age is to start getting tested?

Scott Weissman (NorthShore):
Hi Katie- There are two answers to the question: Generally, we recommend women start screening 10 years before the earliest age of onset in the family. However, if there is a genetic cause to the breast cancer in your family, we generally recommend breast cancer screening start at age 25. You should consider discussing this with your physicians. We would be happy to speak to you about these issues as well at our center as your family history also meets national guidelines to consider not only genetic testing, but also to consider breast MRI screening in addition to mammograms. Thank you for the question.

Stephanie (Park Ridge, IL) - 1:09 PM:
Is there an association between Hormone Replacement Therapy and ovarian cancer?

Scott Weissman (NorthShore):
To the best of my knowledge, I do not believe ovarian cancer has been linked to HRT. Thank you for the question.

Lisa (Evanston, IL) - 1:11 PM:
Does having breast or ovarian cancer increase my risk of other cancers?

Scott Weissman (NorthShore):
Hi Lisa- It depends; having either of these cancers by themselves with no family history of cancer generally will not increase your risk of developing other cancers. If you have one of these cancers and there is a family history of other cancers, then your risk of getting other cancers may be higher as there could be a genetic connection among the cancers in this scenario. Ultimately, this is best determined by meeting with a genetics professional to have the family history assessed (if there is a family history of other cancers). Thank you for the question.

Parker (Naperville, IL) - 1:14 PM:
Is it true that a woman who has had her ovaries removed cannot get ovarian cancer?

Scott Weissman (NorthShore):
Hi Parker- That is not 100% true. When you say "ovaries removed" I am going to assume that you mean ovaries and fallopian tubes. In this situtation (when both ovaries and tubes are removed), there is a very small chance of developing a cancer in the lining of the tissue surrounding the ovaries and tubes called the peritoneum and the cancer is called primary peritoneal cancer (PPC). However, there is some controversy as to whether PPC develops on its own or whether there is a very early stage cancer at the time the ovaries and tubes are removed that is missed and hence it looks like a PPC. Thank you for the question.

Linda (Chicago, IL) - 1:18 PM:
What ways can I prevent ovarian cancer? I have no family history, and have a pretty healthy diet and exercise regime. What worries the most, is that when it is finally detected, it's in the later stages - when has a lower survival rate.

Scott Weissman (NorthShore):
Hi Linda- Certainly a well balanced diet and exercise can help prevent cancers from occurring. With respect to ovarian cancer (OC) specifically, it has been shown that oral contraceptive use can reduce the risk of developing OC by 50% with 5 years use. Having full term pregnancies has also been shown to reduce the risk of OC by at least 15%. Lastly, having a tubal ligation has been shown to reduce the risk by at least 40%. Ultimately, if someone is at high risk of OC either due to strong family history or positive genetic test result (ie, a hereditary risk), the best thing to do is remove the ovaries and fallopien tubes. Thank you for the question.

Linda (Chicago, IL) - 1:21 PM:
I heard that doctors have found a link between infertility and ovarian cancer. Is there a link between fertility drugs and ovarian cancer? Do you know which specific drugs have been linked?

Scott Weissman (NorthShore):
Hi Linda- Another good question. A link has been established between infertility and OC as well as infertility drugs and OC. However, at this time, scientists are not sure which is the true cause meaning is it the infertility itself that is causing the increased risk and the drugs are not contributing or is it purely the drugs. Given this uncertainty, I cannot tell you whether there are any specific drugs to avoid. Thank you for the question.

Scott Weissman (NorthShore) - 1:25 PM:
While there is some down time...please help make a difference during Breast Cancer Awareness Month in October. For each new “Like” on the NorthShore Facebook page, one dollar will be donated to NorthShore’s Breast Cancer Research Fund. In addition, each online gift made to the Breast Cancer Research Fund during October will be matched.

Rachel (Evanston, IL) - 1:25 PM:
What is the difference between symptoms of ovarian cancer and ovarian cysts?

Scott Weissman (NorthShore):
Hi Rachel- I apologize, but that question is out of my scope of knowledge. That question can be best addressed by your OB/GYN. Thank you for your understanding.

Daniel (Skokie, IL) - 1:27 PM:
Are there ways at risk women can prevent ovarian cancer?

Scott Weissman (NorthShore):
Hi Daniel, Please see me first response to Linda from Chicago; this post answers your question. Thank you for your question.

Scott Weissman (NorthShore) - 1:30 PM:
Again, with some down time...we are hosting an event this Monday to evaluate women for breast and ovarian cancer. Please check out this link to learn more:

Gina (Evanston, IL) - 1:30 PM:
What are some of the earliest symptoms of ovarian cancer?

Scott Weissman (NorthShore):
Hi Gina- Some women describe them similar to normal menstrual symptoms. Sometimes pain or experiencing increased frequency of urination. The symptoms can be pretty vague which is what makes ovarian cancer a difficult cancer to detect earlier. Thank you for your question.

Diana (Lombard, IL) - 1:33 PM:
Can wearing a bra all the time cause breast cancer?

Scott Weissman (NorthShore):
Hi Diana- I have never seen an association between bra use or time of use and breast cancer risk. To be honest, since breast cancer tends to develop internally in parts of the breast that are not too close to the skin, I am not sure that bra use would impact a woman's risk. Thank you for the question.

Kristina (Highland Park, IL) - 1:35 PM:
Can breast or ovarian cancer be linked to stress or high blood pressure?

Scott Weissman (NorthShore):
That's a really good question and a tough one to answer. I think most health professionals tend to believe that too much stress on the body is unhealthy, but what is difficult is to actually quantitate how much stress someone is under. For instance, what you may find stressful versus myself may be very different from one another so to study that is quite challenging. I am not sure if we will ever know truly. I am not aware of specific link between high blood pressure and cancer. Thank you for the question.

Jessica (Evanston, IL) - 1:38 PM:
How worried should I be if I find a lump in my breast? Are all forms cancerous?

Scott Weissman (NorthShore):
I would not be too concerned if you find a lump as not all lumps are cancerous. Women can have cysts in the breast, there are types of changes that can occur the form benign tumors (something called a fibroadenoma) and many other non-cancerous lesions, so it is common to have changes in the breast that may present as a lump. However, it is important if you feel a lump to bring it to your physician's attention to have it evaluated. Thank you for the question.

Samantha (Chicago, IL) - 1:42 PM:
How many lymph nodes are removed during axillary dissection?

Scott Weissman (NorthShore):
It varies greatly. There is no set standard and depends on how much of the lymph system is being removed, which is sometimes referred to as a level I, level II or level III with more being taken at each level. Physicians use a technique called sentinel node biopsy to sample the lymph nodes closest to the cancer and if there is cancer in these nodes, they will often remove more. Thank you for the question.

Jen (Evanston, IL) - 1:45 PM:
What are the differences between and benefits of mastectomy & lumpectomy?

Scott Weissman (NorthShore):
The differences between lumpectomy (LY) and mastectomy (MY) is the amount of breast tissue removed. LY is removing just the cancer and some surrounding tissue. MY is removing the entire breast. Both are equally effective at treating breast cancer with the only difference is that the vast majority of women who have LY will also have radiation therapy. Many women who have MY do not need radiation. Sometimes depending on a woman's breast size, LY may not be an option because the cosmetic outcome will not be optimal. Other benefits could be psychological; some women who have breast cancer are not ready to have their entire breast removed. Thank you for the question.

Lisa (Chicago, IL) - 1:50 PM:
After a recent trans-vaginal ultrasound, I was told I have a septated cyst in one of my ovaries, and that, as of now to do a follow-up to watch it. How do physicians know cysts are not cancerous and act immediately?

Scott Weissman (NorthShore):
There are certain features of cysts that allow physicians to determine how concerned they need to be. It's comparable to a mammogram and determining what is suspicious enough to have a women come back and have a biopsy. Radiologists have different grading systems for abnormal imaging findings. Having septations by themselves is not unusual. As more findings show up, this may increase a physicians level of concern and ultimately lead to more invasive tests.

Catherine (Moderator) - 1:51 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

Pam (Chicago, IL) - 1:53 PM:
Germ cell cancer runs in my family and it shows up in the person's late 40's. I am in my mid 40's. Most people who get it die with in months of being diagnosed. Is there any way I can find out if am likely to get it, and what can be done about it now?

Scott Weissman (NorthShore):
Hi Pam- Yes there is. When a very specific type of cancer like that is running in a family, there can be a genetic cause to the cancer. If you are able to determine the genetic cause, then you can be tested to see if you have inherited the predisposition so that an intervention (like preventative removal of the ovaries) can be done so you do not develop the cancer. Sometimes even when a genetic cause cannot be identified, prevention can still be considered to help minimize cancer risk and reduce anxiety about developing it. Thank you for the question.

Scott Weissman (NorthShore) - 1:56 PM:
Help make a difference during Breast Cancer Awareness Month in October. For each new “Like” on the NorthShore Facebook page, one dollar will be donated to NorthShore’s Breast Cancer Research Fund. In addition, each online gift made to the Breast Cancer Research Fund during October will be matched.

Anonymous - 1:56 PM:
Germ cell cancer runs in my family and appears at just about my age. Is it strictly an overian/ testicular cancer? My aunt had it in her colon and my grandfather in his lungs. My doctor told me it is strictly ovarian cancer. Can you explain?

Scott Weissman (NorthShore):
Its not strictly ovarian or testicular and can occur in other organs. I cannot say much more than that without knowing the pathology of the cancers to give a better answer. Hope this helps.

Scott Weissman (NorthShore) - 1:58 PM:
Again, just a reminder, the Center for Medical Genetics is hosting an event to screen women to see if they face an increased risk of breast and ovarian cancer. To learn more, please check out:

Catherine (Moderator) - 2:01 PM:
Thank you again for participating in our chat today. For more information please visit our Kellogg Cancer Center pages.

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