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Surgical Removal of Ovaries & Tubes

Learn about the steps that people at high risk for cancer can take to manage their risk and protect their health.

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Bilateral Oophorectomy and Breast Cancer Risk in BRCA1 and BRCA2 Mutation Carriers
Kotsopoulos J, Narod S et. al. J Natl Cancer Inst. 2016 Sep 6;109(1). pii: djw177. doi: 10.1093/jnci/djw177. Print 2017 Jan.

Findings from this large prospective study support a role of oophorectomy for the prevention of premenopausal breast cancer in BRCA2, but not BRCA1 mutation carriers. These findings warrant further evaluation.

Uterine Cancer After Risk-Reducing Salpingo-oophorectomy Without Hysterectomy in Women With BRCA Mutations.
Shu, CA, Pike, MC, Jotwani, AR, et al., "Uterine Cancer After Risk-Reducing Salpingo-oophorectomy Without Hysterectomy in Women With BRCA Mutations," JAMA Oncology, Vol. 2, No. 11, pp. 1434-1440, November 2016.

Conclusions and Relevance: Although the overall risk for uterine cancer after RRSO was not increased, the risk for serous/serous-like endometrial carcinoma was increased in BRCA1+ women. This risk should be considered when discussing the advantages and risks of hysterectomy at the time of RRSO in BRCA1+ women.

Impact of Oophorectomy on Cancer Incidence and Mortality in Women With a BRCA1 or BRCA2 Mutation
Finch, AP1 Lubinski, J, Møller, P, et al. "Impact of Oophorectomy on Cancer Incidence and Mortality in Women With a BRCA1 or BRCA2 Mutation," Journal of Clinical Oncology, Vol. 32, No. 15, pp. 1547-1553, May 2014.

Association of Risk Reducing Surgery in BRCA 1 or BRCA 2 Mutation Carriers with Cancer Risk and Mortality
Domchek, et. al. JAMA. 2010;304(9):967-975.

Conclusions: Among a cohort of women with BRCA1 and BRCA2 mutations, the use of risk-reducing mastectomy was associated with a lower risk of breast cancer; risk-reducing salpingo-oophorectomy was associated with a lower risk of ovarian cancer, first diagnosis of breast cancer, all-cause mortality, breast cancer–specific mortality, and ovarian cancer–specific mortality.

Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers
Timothy R. Rebbeck, Noah D. Kauff and Susan M. Domchek. JNCI J Natl Cancer Inst (2009) 101 (2): 80-87.

Conclusion: The summary estimates presented here indicate that RRSO is strongly associated with reductions in the risk of breast, ovarian, and fallopian tube cancers and should provide guidance to women in planning cancer risk reduction strategies.

Risk-Reducing Salpingo-Oophorectomy for the Prevention of BRCA1- and BRCA2-Associated Breast and Gynecologic Cancer: A Multicenter, Prospective Study
Noah D. Kauff, et. al. JCO March 10, 2008 vol. 26 no. 8 1331-1337.

Conclusion: The protection conferred by RRSO against breast and gynecologic cancers may differ between carriers of BRCA1 and BRCA2 mutations. Further studies evaluating the efficacy of risk-reduction strategies in BRCA mutation carriers should stratify by the specific gene mutated.

Primary Fallopian Tube Malignancies in BRCA-Positive Women Undergoing Surgery for Ovarian Cancer Risk Reduction
Michael J. Callahan, Christopher P. Crum, et. al. JCO September 1, 2007 vol. 25 no. 25 3985-3990.

Conclusion: The distal fallopian tube seems to be the dominant site of origin for early malignancies detected in approximately 6% of women undergoing ovarian cancer risk-reduction surgery.

Mortality after bilateral salpingo-oophorectomy in BRCA1 and BRCA2 mutation carriers: a prospective cohort study
Domchek, S, et. al. Lancet Oncol. 2006 Mar;7(3):223-9.

Conclusion: If confirmed, the finding that BPSO improves overall survival and cancer-specific survival in women with BRCA mutations will complement our existing knowledge of cancer-risk reduction associated with BPSO. Together, these data could give information to women who are considering genetic testing.

Effect of Short-Term Hormone Replacement Therapy on Breast Cancer Risk Reduction After Bilateral Prophylactic Oophorectomy in BRCA1 and BRCA2 Mutation Carriers: The PROSE Study Group
Timothy R. Rebbeck, et. al. JCO November 1, 2005 vol. 23 no. 31 7804-7810.

Conclusion: Short-term HRT use does not negate the protective effect of BPO on subsequent breast cancer risk in BRCA1/2 mutation carriers.

Breast Cancer Risk Following Bilateral Oophorectomy in BRCA1 and BRCA2 Mutation Carriers: An International Case-Control Study
Eisen, A, Narod, S, et. al. J Clin Oncol. 2005 Oct 20;23(30):7491-6.

Conclusion: Oophorectomy is an effective means of reducing the risk of breast cancer in carriers of BRCA1 mutations. The data suggest oophorectomy is protective in BRCA2 carriers as well, but needs to be confirmed in other studies

The effect of total hysterectomy on specific sexual sensations
Martha F. Goetsch. American Journal of Obstetrics and Gynecology, Volume 196, Issue 6: p. 1922-1927, June 2005.

Conclusion: An indicated total hysterectomy will likely increase sexual satisfaction and not change the effect of breast stimulation. The few women with disturbingly reduced sexual sensation deserve assessment and treatment.

Risk-Reducing Salpingo-Oophorectomy in BRCA Mutation Carriers: Role of Serial Sectioning in the Detection of Occult Malignancy
C. Bethan Powell, Eric Kenley, Lee-may Chen, Beth Crawford, Jane McLennan, Charles Zaloudek, Miriam Komaromy, Mary Beattie, John Ziegler. Journal of Clinical Oncology, Volume 23, Number 1:p. 127-132, January 2005.

Conclusion: A rigorous operative and pathologic protocol for RRSO increases the detection rate of occult ovarian malignancy in BRCA mutation carriers nearly seven-fold. If confirmed, this finding will alter postoperative management because additional staging, chemotherapy, and follow-up may be necessary in affected women.

BRCA germline mutations in Jewish women with uterine serous papillary carcinoma
Ofer Lavie, Gila Hornreich, Alon Ben-Arie, Gad Rennert, Yoram Cohen, Rehuven Keidar, Shlomi Sagi, Efrat Levy Lahad, Ron Auslander and Uzi Beller. Gynecologic Oncology, Volume 92, Number 2: p. 521-524, February 2004.

Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 Mutation
Finch, A, Narod, S, et. al. JAMA. 2006. 296(2):185-192.

CONCLUSION: Oophorectomy is associated with reduced risk of ovarian and fallopian tube cancer in high-risk women, although there is a substantial residual risk for peritoneal cancer in BRCA1 and BRCA2 mutation carriers following prophylactic salpingo-oophorectomy.

Effect of Prevention Strategies on Survival and Quality-Adjusted Survival of Women With BRCA1/2 Mutations: An Updated Decision Analysis
Victor R. Grann, Judith S. Jacobson, Dustin Thomason, Dawn Hershman, Daniel F. Heitjan, Alfred I. Neugut. Journal of Clinical Oncology. Volume 20, Issue 10: p. 2520-2529, May 2002.

Prophylactic Oophorectomy in Carriers of BRCA1 or BRCA2 Mutations
Timothy R. Rebbeck, Ph.D., Henry T. Lynch, M.D., Susan L. Neuhausen, Ph.D., Steven A. Narod, M.D., Laura van't Veer, Ph.D., Judy E. Garber, M.D., M.P.H., Gareth Evans, M.D., Claudine Isaacs, M.D., Mary B. Daly, M.D., Ph.D., Ellen Matloff, M.S., Olufunmilayo I. Olopade, M.D., Barbara L. Weber, M.D. New England Journal of Medicine. Volume 346: p. 1616-1622, May 2002. (Note: a review of the above two articles on oophorectomy and breast and ovarian cancer risk appears in the same issue of the New England Journal of Medicine.)

Outcome of Preventive Surgery and Screening for Breast and Ovarian Cancer in BRCA Mutation Carriers
Lauren Scheuer, Noah Kauff, Mark Robson, Bridget Kelly, Richard Barakat, Jaya Satagopan, Nathan Ellis, Martee Hensley, Jeff Boyd, Patrick Borgen, Larry Norton, Kenneth Offit. Journal of Clinical Oncology. Volume 20, Issue 5: p. 1260-1268, March 2002.

Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations: a case-control study
Steven A Narod, Ping Sun, Parviz Ghadirian, Henry Lynch, Claudine Isaacs, Judy Garber, Barbara Weber, Beth Karlan, David Fishman, Barry Rosen, Nadine Tung, Susan L Neuhausen. Lancet. Volume 12, Issue 357(9267): p. 1467-70, May 2001.

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