Prophylactic oophorectomy-pro
Various guidelines try to define the high risk patient for whom a prophylactic oophorectomy can be recommended. NICE says:“In high-risk women and mutation carriers, cohort studies of risk-reducing surgeries (mastectomy and salpingo-oophorectomy) showed substantially reduced risks for breast or ovarian cancer, with breast cancer reduced by 85% to 100% with mastectomy and by 37% to 100% with oophorectomy, and ovarian cancer reduced by 69% to 100% with oophorectomy or salpingo-oophorectomy.”American Cacner Society says: “Women with a strong family history of ovarian and/or breast cancer in first-degree relatives but who don’t have an abnormal BRCA1 or BRCA2 gene may have a different abnormal gene that’s not routinely tested for or recognized. This other abnormal gene may increase ovarian and breast cancer risk. So the guidelines recommend that women with a strong family history without an abnormal BRCA1 or BRCA2 gene have prophylactic BSO to reduce their cancer risk once they’re done having children.”
Women who have a strong family history of either ovarian or breast cancer may carry a deleterious mutation and must be presumed to be at higher-than-average risk, even if they have not been tested, because there could be other .
American College of Obstetricians and Gynecologists. Elective and risk-reducing salpingo-oophorectomy. ACOG practice bulletin; no. 89. Obstet Gynecol 2008 Jan;111(1):231-41
American Cancer Society: http://www.breastcancer.org/research-news/20100926, 2013
Urban N, Hawley S, Janes H, Karlan BY, Berg CD, Drescher CW, Manson JE, Palomares MR, Daly MB, Wactawski-Wende J, et al. Identifying post-menopausal women at elevated risk for epithelial ovarian cancer. Gynecol Oncol. 2015 Nov; 139(2):253-60.
Berek JS, Chalas E, Edelson M, Moore DH, Burke WM, Cliby WA, Berchuck A; Society of Gynecologic Oncologists Clinical Practice CommitteeProphylactic and risk-reducing bilateral salpingo-oophorectomy: recommendations based on risk of ovarian cancer.Obstet Gynecol. 2010 Sep;116(3):733-43.