Four women have groundbreaking two-in-one surgery to reduce their risk of ovarian cancer while undergoing a C-section

  • The four women were all at higher risk of the disease due to gene changes

Four women underwent a groundbreaking two-in-one operation to reduce their risk of ovarian cancer while having a caesarean section.

The women, who were treated at University College London Hospitals (UCLH), were all carriers of the BRCA1 or BRCA2 gene changes, which put them at higher risk of the disease.

Surgery to reduce the risk for these patients is usually a standalone procedure to remove the fallopian tubes and ovaries. But experts decided to see if it was possible in combination with a caesarean section.

The first two-in-one operation was performed in 2018 and three more have been completed since then.

Scientists say that given its success, it could be offered routinely to women at higher risk of ovarian cancer who need a caesarean section.

Claire Rodrigues Lee, 45, was one of four women who underwent a groundbreaking two-in-one surgery to reduce the risk of ovarian cancer while having a caesarean section

The women, who were treated at University College London Hospitals (pictured), were all carriers of the BRCA1 or BRCA2 gene changes, which put them at greater risk of the disease.

The women, who were treated at University College London Hospitals (pictured), were all carriers of the BRCA1 or BRCA2 gene changes, which put them at greater risk of the disease.

Women who carry these gene changes – including actress Angelina Jolie – have an 11 to 68 percent risk of developing ovarian cancer, compared to a 2 percent risk in the general population.

Case study: Claire Rodrigues Lee

Claire Rodrigues Lee, 45, from London, was one of four women who underwent the operation. She received it in 2019, at the same time as the birth of her son, her second child.

She said: ‘As a carrier of the BRCA2 gene change, I knew I was at higher risk of ovarian cancer and I wanted to have the risk-reducing surgery as soon as possible after the second birth.

‘I looked online to see how soon I could have the operation after giving birth and came across the combined operation, because the first case had just been completed, so I wanted to know if it would be possible for me.

‘At that point I contacted the team at UCLH who carried out the operation – and eventually made plans to have the combined operation carried out there. I’m glad I did that, and it meant I didn’t have to go to the hospital for surgery after giving birth.

‘Recovery was no different after combining surgery with just a caesarean section – my first child was born via caesarean section, so I knew what to expect.

BRCA gene changes are linked to about 15 percent of ovarian cancers.

Risk-reducing surgery is the only proven way to reduce mortality from ovarian cancer and reduce the risk of the disease by at least 95 percent.

All four women, who were aged between 40 and 45, were referred to UCLH during their pregnancies between 2018 and 2022. They were all about to give birth by caesarean section and had no intention of having any more children.

The patients did not have to stay in hospital longer than after a caesarean section alone, and none of them had serious complications.

Professor Adam Rosenthal, a consultant gynecologist at UCLH, said: ‘Offering this two-in-one operation could be very beneficial to other women at high risk of ovarian cancer, who would then avoid the need for separate risk-reducing surgery .

‘The number of women giving birth by caesarean section is increasing worldwide, as is the number of women who know that they are carriers of a gene change that increases the risk of ovarian cancer.

‘This means that many more women may be suitable for the combined procedure. There is also a potential cost savings for any healthcare system by not requiring two separate surgeries.”

Both men and women can have defective BRCA1 and BRCA2 genes and according to Cancer Research UK these are found in around one in 400 people.

Those who inherit defective versions of these genes are at increased risk of developing cancers of the ovaries, breasts, prostate and pancreas.

The four cases were reported in the Journal of Obstetrics and Gynaecology.