Hollywood actress Angelina Jolie has had her ovaries and fallopian tubes removed as a precaution. Jolie released the news through the New York Times on March 24: she has had her ovaries and fallopian tubes removed as a precautionary measure for fear of developing ovarian cancer. Angelina? Jolie wrote that she has a 50% risk of ovarian cancer and an 87% risk of breast cancer due to a genetic defect in herself. She revealed this move as another difficult choice after she had her mammary gland removed in May 2013. At the same time, she wants other women to know that a positive test result is not the same as going straight to surgery, and that they should choose the method that works best for them personally. Cancer is often determined by a variety of factors, and eliminating all risks is impossible. Genetic mutations do not necessarily mean that the disease will develop, and it is prudent in China whether to perform prophylactic resection. Dr. Kang Yu, Deputy Chief Physician of Obstetrics and Gynecology Hospital of Fudan University, will tell you a few things you should know about “to cut” or “not to cut”: 1. What is BRCA1/2? Most people know BRCA1/2 from when Jolie had her mammary gland removed. BRCA1/2, or breast cancer susceptibility genes 1 and 2, is a “good” gene that inhibits the occurrence of malignant tumors, but when it is mutated, this protective effect is gone. Generally, the risk of breast cancer for those with BRCA1/2 mutation is 80%, but the risk distribution of ovarian cancer is different: 55% for those with BRCA1 mutation and 25% for those with BRCA2 mutation. 2. What are the pros and cons of resection? For people with BRCA1/2 mutations, the benefit of prophylactic resection is to reduce the risk of developing breast or ovarian cancer. However, since the gene is associated with many cancers, such as colorectal cancer, peritoneal cancer, and endometrial cancer in addition to ovarian cancer, removal of the ovaries does not reduce the risk of other related cancers. As we all know, ovaries have two main functions: endocrine and ovulation, and removal of ovaries has an important impact on women. With the decline of estrogen in the body, women will experience perimenopausal symptoms such as hot flashes, irritability, poor sleep and osteoporosis, and the risk of cardiovascular disease will also increase. 3. Can mutations be prevented and treated? BRCA1/2 mutations are “autosomal dominant” and generally cannot be prevented. However, there are some corresponding therapeutic drugs being developed, such as the clinical trial for BRCA1/2 mutation families in the world’s top-ranked cancer research center MD Anderson’s “Shoot the Moon Project”, which targets the inhibitor PARP to improve the prognosis of these special patients. It is expected that this study will enter the clinical treatment field soon. 4. Is it advisable to save for a rainy day? For Julie, such a choice is necessary because she has an obvious family history – her mother, aunt, grandparents, uncle and aunt all have a history of cancer. This time it was said that ovarian cysts were found, and although they may be benign, the doctors recommended the option of removing the ovaries and fallopian tubes because of the presence of the first two points. 5. What is the advice for women? Advice 1: There is absolutely no need for people to panic about this. Generally speaking, if a woman has no ovarian cancer in her family, her lifetime chance of developing ovarian cancer is only about 1.4%. First-degree relatives such as sisters or mothers and daughters who have two unilateral breast or ovarian cancers, one of whom is under 50 years old, or one of whom has bilateral breast cancer, it is best to have a genetic test for BRCA1/2. If there is a family history of BRCA1/2 mutation and tumor, prophylactic resection can be performed at the age of 40 or so. Advice 2: Get regular medical checkups to prevent disease before it happens Be good at life and choose a healthy lifestyle. Face the disease together with your family and doctor and choose the right treatment for you.