Angelina Jolie made headlines when she revealed she'd had a double mastectomy last year. But her cancer-prevention surgeries are not over yet, the actress said recently.
"There's still another surgery to have, which I haven't [had] yet," Jolie told Entertainment Weekly recently. "I'll get advice from all these wonderful people who I've been talking to, to get through that next stage."
Jolie carries a mutation in the BRCA1 gene and had an 87 percent risk of developing breast cancer, according to the op-ed she wrote in The New York Times last May. She had the preventive mastectomy to reduce this risk.
But Jolie is also at increased risk for developing ovarian cancer.
About 15 to 40 percent of women who have a BRCA1 or BRCA2 mutation will develop ovarian cancer over the course of their lifetime, compared to 1.4 percent of women in the general population, according to the National Cancer Institute (NCI).
Ovarian cancer is rare, representing 1.3 percent of all new cancer cases in the United States each year, but it is deadly. An estimated 22,000 women are diagnosed with ovarian cancer each year, and an estimated 14,000 will die of the disease, according to 2013 data from the NCI. For comparison, it is estimated that about 232,000 women will be diagnosed with breast cancer each year, and about 40,000 women will die of that disease. [5 Things Women Should Know About Ovarian Cancer]
The greatest risk factor for developing ovarian cancer is a family history of the disease, because it's a sign of having inherited a mutated BRCA gene. A woman's risk of the disease triples if her mother, daughter or sister has developed ovarian cancer.
Jolie's mother died of ovarian cancer at age 56. In her New York Times op-ed last May, Jolie wrote she had chosen to undergo a mastectomy first, because her risk of breast cancer was higher than her risk of ovarian cancer, and because that surgery was more complex.
For women with BRCA gene mutations, one option to reduce the risk of cancer is to surgically remove the ovaries, which is called prophylactic oophorectomy. Removing the ovaries reduces the risk of developing ovarian cancer by 90 percent. Having the surgery puts women into early menopause, because they no longer ovulate.
Although women with BRCA gene mutations are at higher risk for ovarian cancer, they are a minority of women who develop this cancer. About 90 percent of ovarian-cancer cases have no clear genetic link. Other factors that have been linked with an increased risk of the disease include fertility drugs, hormone replacement therapy after menopause and obesity.
In general, a woman's risk of ovarian cancer rises with age. Overall, one in 72 women will be diagnosed with ovarian cancer during their lifetime. There currently are no established screening tests for ovarian cancer.