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Researchers have studied the reduction of ovarian cancer risk after risk-reducing salpingo-oophorectomy (RRSO).The amount of risk reduction achieved varies according to how much risk was present prior to surgery.
In a large retrospective study, less than 1% of women with BRCA mutations who chose risk-reducing oophorectomy developed primary peritoneal cancer (2 of 247 or .08% ) compared with 19.9% (58 of 292) of women who didn’t have surgery ended up with ovarian cancer or primary peritoneal cancer. This represents a 96% risk reduction for ovarian cancer after risk-reducing salpingo-oophorectomy.
The largest study to date showed that BRCA mutation-carriers who undergo risk-reducing oophorectomy have an 80% reduced risk of ovarian, fallopian tube, and peritoneal cancer and an estimated 77% decreased risk of death from all causes. This confirms the 2010 study that linked RRSO in mutation carriers to increased survival.
A study of 122 BRCA positive women undergoing risk-reducing oophorectomy found that about 6% of these women had cancer at the time of risk-reducing surgery. Of these women, all had cancers originating in their fallopian tube. This study suggests that much of the ovarian cancer in BRCA carriers may begin in the fallopian tubes.
It is important to be certain that the surgeon performing prophylactic oophorectomy is familiar with the associated fallopian tube risk in mutation carriers and that the pathology department that reviews the ovaries performs what is known as "serial sectioning" where they look at many cross sections of the fallopian tubes to be certain that a cancer is not present.