Early Onset Of Menopause Linked To BRCA Gene Mutations

Early Onset Of Menopause

Previous research has shown women who have preexisting abnormalities in the BRCA gene have a greater risk of suffering breast and ovarian cancers within their lifetimes. Recent research, published in the journal Cancer, found the same defects in the BRCA gene may also prematurely phase women into early menopause.

In normal cells, BRCA1 (breast cancer susceptibility gene 1) and BRCA2 (breast cancer susceptibility gene 2) help ensure the stability of the cell’s genetic material (DNA). They are supposed to prevent uncontrolled cell growth. However a mutation of these genes has been linked to the development of hereditary breast and ovarian cancer.

A woman’s lifetime risk of developing breast and or ovarian cancer increases exponentially if she inherits a harmful mutation in BRCA1 or BRCA2. About 12 percent of women (120 out of 1,000) in the general population will develop breast cancer compared to nearly 60 percent (600 out of 1,000) whom have inherited a harmful mutation in BRCA1 or BRCA2. In other words, a woman who has inherited a detrimental mutation in BRCA1 or BRCA2 is about five times more likely to incur breast cancer.

Ovarian cancer estimates indicate 1.4 percent of the general population will be diagnosed versus 15 to 40 percent with the inherited mutation, according to the National Cancer Institute at the National Institutes of Health.

The study was designed to specifically determine whether women with the BRCA1 or BRCA2 mutation had an earlier onset of menopause compared to unaffected women.

Study data was collected from the Cancer Risk Program at UCSF and the northern California site of the Study of Women’s Health Across the Nation, a project of the University of California in partnership with Davis and Kaiser Permanente.

Female subjects reviewed were on the University of California, San Francisco (UCSF) cancer risk registry. They either lived in northern California, or near the geographical location, and were predominantly Caucasian.

Researchers observed nearly 400 individual carriers of the mutation and compared their onset of menopause to a pool of 765 women in the same region without the mutation. Those with the BRCA 1/2 were found to undergo menopause at or before age 50. The average age of the non-affected group was closer to 53.

The study revealed an even earlier onset among heavy smokers (those who smoked 20 or more cigarettes a day), at 46. Smoking has been shown to effect estrogen.

The investigators acquiesce to the realization more research will be required to further reinforce their results, given the limited size and primary demographics used to ascertain their immediate findings. Funding for the study was provided by National Institutes of Health (NIH) grants.

The researchers who shared in the controlled study linking BRCA genes and early menopause included senior author Mitchell Rosen, MD, director of the UCSF Fertility Preservation Center and associate professor in the University of California, San Francisco (UCSF) Department of Obstetrics, Gynecology and Reproductive Sciences — lead author Wayne Lin, MD, MPH, a fellow at the Brigham and Women’s Hospital at Harvard Medical School — co-author Lee-may Chen, MD, a UCSF professor and director of the Division of Reproductive Endocrinology in the Department of Obstetrics, Gynecology and Reproductive Services — Dr. Marcelle Cedars, and Dr. Mary Beattie.

Dr. Chen rationalized, “The data may help women understand that their childbearing years may be even more limited by earlier menopause, so that they can make decisions about their reproductive choices and cancer risk-reducing surgery.”

Genetic testing can assess if the mutations are present in the BRCA1 and BRCA2 DNA. Screening should be considered especially if a relative has been found to have these abnormalities. It is stressed that not all women who inherit a harmful BRCA1 or BRCA2 mutation will develop breast or ovarian cancer, or an early onset menopause. It is recommended people modify lifestyle behaviors in order to limit their risks associated with cancer and illness in general.

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