Prophylactic oophorectomy in women at increased cancer risk

Curr Opin Obstet Gynecol. 2007 Feb;19(1):27-30. doi: 10.1097/GCO.0b013e32801195da.


Purpose of review: Bilateral prophylactic salpingo-oophorectomy is widely used for cancer risk reduction in women with BRCA1/2 mutations. Bilateral prophylactic salpingo-oophorectomy significantly reduces breast cancer risk by approximately 50% and ovarian cancer risk by 80-95% but may be accompanied by menopausal symptoms, impaired quality of life and accelerated bone loss. Therefore, decisions regarding the timing of bilateral prophylactic salpingo-oophorectomy and the use of post-bilateral prophylactic salpingo-oophorectomy hormone replacement therapy must be carefully considered.

Recent findings: Over the last year, studies have further examined issues related to quality of life associated with bilateral prophylactic salpingo-oophorectomy and have demonstrated that hormone replacement therapy following bilateral prophylactic salpingo-oophorectomy in unaffected women does not negate the breast cancer risk reduction that bilateral prophylactic salpingo-oophorectomy provides. Studies have provided additional information on the residual risk of cancer following bilateral prophylactic salpingo-oophorectomy, have demonstrated its benefit in Lynch syndrome and have suggested a short-term mortality benefit following bilateral prophylactic salpingo-oophorectomy in BRCA1/2 mutation carriers.

Summary: We review the recent studies regarding bilateral prophylactic salpingo-oophorectomy and their implications for the clinical management of women who are at increased cancer risk.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Breast Neoplasms / prevention & control*
  • Colorectal Neoplasms, Hereditary Nonpolyposis / surgery
  • Decision Making
  • Fallopian Tubes / surgery
  • Female
  • Genes, BRCA1
  • Genes, BRCA2
  • Genetic Predisposition to Disease
  • Germ-Line Mutation
  • Humans
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / prevention & control*
  • Ovariectomy*
  • Quality of Life