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Debate 3A - Should Women with BRCA Mutations be Offered Bilateral Salpingectomy with Delayed Oophorectomy for Ovarian Cancer Risk Reduction?

Yes

from Section II - Screening, Prevention, and Early Diagnosis

Published online by Cambridge University Press:  20 July 2023

By
Thomas Boerner  and
Kara Long Roche
Edited by
Dennis S. Chi ,
Nisha Lakhi  and
Nicoletta Colombo
Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

The fimbriated end of the fallopian tube plays a pivotal role in the pathogenesis of pelvic high-grade serous carcinomas (HGSC). While risk-reducing salpingo-oohprectomy (RRSO) is the standard of care for patients with genetic risk for developing HGSC, the detrimental effects of premature menopause on both health and quality of life are unacceptable to many patients. Risk-reducing early salpingectomy with delayed oophorectomy (RRESDO) has the potential to offer risk-reduction, without the toxicity of premature menopause and infertility. An individualized “previvorship” plan incorporating this option allows for patient-centered planning, with the potential for enhanced quality of life, earlier detection of precursor lesions, and possibly a greater impact in risk-reduction.

Type
Chapter
Information
50 Big Debates in Gynecologic Oncology , pp. 11 - 12
Publisher: Cambridge University Press
Print publication year: 2023

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References

National Comprehensive Care Network. Genetic/familial high-risk assessment: breast, ovarian, and pancreatic. Version 2. 2021. Available from: www.nccn.orgGoogle Scholar
Rebbeck, TR, et al. Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 2002;346(21):1616–1622CrossRefGoogle ScholarPubMed
Mai, PL, et al. Prospective follow-up of quality of life for participants undergoing risk-reducing salpingo-oophorectomy or ovarian cancer screening in GOG-0199: and NRG Oncology/GOG Study. Gynecol Oncol 2020;156(1):131–139.CrossRefGoogle ScholarPubMed
Long, Roche KC, et al. Risk-reducing salpingectomy: let us be opportunistic. Cancer 2017;123(10):1714–1720.CrossRefGoogle Scholar

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