Ovarian Cancer and BRCA: What Your Family History Means for Your Risk
When a close family member is diagnosed with ovarian or breast cancer, it raises a natural and important question: what does that mean for me? In some cases, the answer involves a genetic mutation — most notably in the BRCA1 or BRCA2 genes — that substantially increases a woman’s lifetime risk of developing certain cancers, including ovarian cancer. Understanding your family history, and knowing when to seek genetic counseling, can be one of the most important things you do for your long-term health.
“The doctor and his entire staff are amazing!!! The doctor listens to his patients. Very professional office. The doctor is amazing and listens to his patients. He took his time and explained EVERYTHING in a way that I would understand. He is so patient and very understanding.”
– Alliance OB/GYN Patient Testimonial
What Are BRCA1 and BRCA2?
BRCA1 and BRCA2 are genes that, under normal circumstances, help suppress tumor growth by repairing DNA damage. When a harmful mutation is present in either gene, that protective function is compromised — and the risk of developing breast cancer, ovarian cancer, and several other malignancies rises significantly.
In the general population, the lifetime risk of ovarian cancer is roughly 1 to 2 percent. For women with a BRCA1 mutation, estimates place that lifetime risk between 35 and 70 percent. Women with a BRCA2 mutation face a somewhat lower but still substantially elevated risk — typically in the range of 10 to 30 percent. These are striking numbers, and they underscore why identifying a mutation before a cancer develops is so valuable.
It’s important to understand that having a BRCA mutation does not mean cancer is inevitable. It means risk is elevated, and that elevated risk warrants a proactive, structured management plan developed with your healthcare provider.
What Family History Patterns Should Prompt a Conversation?
Not every case of breast or ovarian cancer in a family is linked to a BRCA mutation, but certain patterns are associated with a higher likelihood. Consider speaking with your provider about genetic counseling if your family history includes:
Multiple relatives on the same side of the family diagnosed with breast or ovarian cancer, particularly if diagnoses occurred at younger ages.
A first-degree relative — a parent, sibling, or child — with a known BRCA mutation.
A family member with breast cancer diagnosed before age 50, which can be a hallmark of hereditary risk.
Male breast cancer in the family, which is rare and frequently associated with BRCA2.
Ashkenazi Jewish ancestry, which is associated with a higher frequency of specific BRCA mutations in the population.
A personal or family history of ovarian, fallopian tube, or peritoneal cancer, which are grouped together in terms of BRCA-associated risk.
Even if your family history is incomplete — perhaps because relatives are estranged, adopted family members have unknown histories, or medical records are unavailable — sharing what you do know is a valuable starting point for your provider.
What Does Genetic Counseling and Testing Involve?
Genetic counseling begins with a thorough review of your personal and family medical history. A genetic counselor or your OB/GYN provider can help you assess your likelihood of carrying a mutation and discuss whether testing makes sense for you. If you decide to proceed, genetic testing is typically done through a blood or saliva sample.
If testing reveals a BRCA mutation, that result doesn’t change overnight, but it does open the door to a range of options. These may include enhanced surveillance with more frequent imaging, chemoprevention strategies, or, for women who have completed childbearing, risk-reducing surgical options such as prophylactic salpingo-oophorectomy (removal of the ovaries and fallopian tubes). Every decision is deeply personal and should be made carefully with your provider after a thorough discussion of risks, benefits, and your individual circumstances.
“Dr. Clement Hsiao is very knowledgeable. I’ve been seeing him for probably about 18 years. He delivered both of my kids as well. I have always had so much confidence in this office with their policies, their procedures, and how they treat their patients. They are caring, spend a lot of time with their patients, and their follow up is phenomenal.”
– Alliance OB/GYN Patient Testimonial
What If You Test Negative?
A negative test result — meaning no BRCA mutation was detected — is reassuring, but it doesn’t eliminate all risk. Other genes beyond BRCA1 and BRCA2 can also increase cancer risk, and most ovarian cancers occur in women without any known hereditary mutation. Routine gynecologic care, including regular pelvic exams and prompt attention to any new or unusual symptoms, remains important regardless of genetic test results.
Symptoms Worth Knowing
One of the challenges of ovarian cancer is that early symptoms are often vague and easy to attribute to other causes. Women who carry a BRCA mutation — and all women — should be aware of persistent symptoms that may warrant evaluation: bloating that doesn’t resolve, pelvic or abdominal pain, difficulty eating or feeling full quickly, and urinary urgency or frequency. These symptoms, especially when they’re new and occur regularly, should be discussed with your provider.
Alliance OB/GYN: Your Partner in Prevention
At Alliance Ob/Gyn, we understand that navigating genetic risk can feel overwhelming. Our team is here to provide compassionate, individualized guidance at every step — from reviewing your family history to coordinating appropriate testing and follow-up care. Whether you’re concerned about a specific family history pattern or simply want to ensure you’re doing everything you can to protect your health, we’re here to help. Visit our gynecology services page to learn more, or contact our Alpharetta office at (770) 777-4933 to schedule your appointment.
