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Oophorectomy as a preventative measure for ovarian cancer

Mary B Daly

The discovery of germline mutations, including mutations in BRCA1/2 and the Lynch syndrome genes, which confer an increased risk of ovarian cancer, has identified a small group of women at significantly increased risk of the disease. Since screening and chemopreventive options for ovarian cancer are very limited, bilateral salpingo-oophorectomy (BSO) has become the standard of care for risk reduction in this population. BSO reduces the risk of subsequent ovarian cancer by 71–96% and also reduces the risk of breast cancer by 50%. There is a small risk of primary peritoneal cancer after surgery. Most women are candidates for the minimally invasive laparoscopic procedure. Uptake of BSO among mutation carriers is high, and is related to age, parity, family history and personal history of breast cancer. There is a growing appreciation of the short- and long-term consequences of surgical menopause and of the need for prospective studies to characterize the impact of BSO over the lifetime.