Prophylactic hysterectomy for post-menopausal women with BRCA gene – pro
Yes. BRCA carriers have an increased risk of breast cancer, but also of ovarian cancer, which rises with age. Delaying RRSO until the age of 50 might be reasonable for BRCA2 mutation carriers; however, as shown in other studies, this strategy might not provide breast cancer risk reduction.ACOG and the SGO agree that RRSO in these women should be performed after completion of childbearing or by the age of 40 after discussing risks vs. benefits of surgery. It is usually recommended at age 40, but it causes vasomotor symptoms at that age, which it should not cause as often in post-menopausal women. The risk by age 40 is about 3% and jumps to about 10% by the age of 50. It has been shown that RRSO can reduce the risk of ovarian cancer by 80%
Lewis KE, Lu KH, Klimczak AM, Mok SC. Recommendations and Choices for BRCA Mutation Carriers at Risk for Ovarian Cancer: A Complicated Decision. Cancers (Basel). 2018;10(2):57.
Stan DL, Shuster LT, Wick MJ, Swanson CL, Pruthi S, Bakkum-Gamez JN. Challenging and complex decisions in the management of the BRCA mutation carrier. J Womens Health (Larchmt). 2013;22(10):825834. doi:10.1089/jwh.2013.4407