BRCA2 mutation

I am a breast cancer survivor who happens to have the BRCA2 mutation.  I have been told that this increases my risk of getting ovarian cancer by 25% by the time I'm 70 years old.  Therefore, in an attempt to monitor my condition I have an ultra sound of my ovaries every 6 months and a CA125 drawn every 3months.  My CA125 has been within normal range until recently it was a 45.  It jumped 11 points in 3 months.  My ultrasound looks noral.  I am on Tamoxifen for 3 1/2 more years however I did have my first period in a year and a half 45 days ago.  Should I be overly concerned about my CA125 elevated level?  Do I need to just throw myself into early menopause and remove the ovaries?  I am 40 years old and was 38 when diagnosed with DCIS breast cancer.  I had a bilateral mastectomy with reconstruction, 8 rounds of chemo over 6 months, my cancer was also 100% estrogen positive.  Please let me know what you think.  Thanks so much!

[CCF-RN,MSN-rf]

Dear slovak:  Although screening for ovarian cancer with CA125 measurements and ultrasound examinations is frequently done in women who are carriers of BRCA1 or BRCA2, their effectiveness remains uncertain.  Given the complexities of your individual situation, it may be helpful to have a detailed discussion with a medical oncologist, gynecologic oncologist and perhaps even a genetic counselor to disscuss the pros and cons of the various options available to you.

[slovak]

Thanks, I've done all of that.  I see my regular oncologist plus a gyn/onco every 6 months.  They seem to be on top of the situation.  I just want as many opinions as possible.  I've talked with a genetics counselor and both oncologists seem to think I should wait until I'm closer to going through menopause to remove my ovaries.  I'm 40 now they both think they should come out before 50 because of the gene.  Now, if the ovaries cease to look normal on the ultra sound and the CA125 starts getting higher each time then they will come out sooner.  Since the discovery of this gene is relatively new, it makes my situation more difficult.  I am having to go a lot on my gut feelings and a great deal of prayer.  Like you said in your response a lot of the data on these tests and my mutation are uncertain.