Our Summary

This study looked at the risk of breast cancer in women who had a hysterectomy (surgery to remove the uterus) with or without additional surgery to remove both ovaries and fallopian tubes (bilateral salpingo-oophorectomy). They analyzed data from over 49,000 women who had these surgeries for non-cancerous reasons between 2001 and 2015.

They found that women who had both their uterus and ovaries removed had a 14% lower risk of developing breast cancer compared to those who only had their uterus removed. However, the women who had both surgeries were also more likely to die from any cause.

This suggests that while removing the ovaries can reduce the risk of breast cancer, it may also have other health risks. Therefore, women considering these surgeries should be made aware of these potential benefits and risks.

FAQs

  1. Does removing both the uterus and ovaries reduce the risk of developing breast cancer?
  2. What are the potential health risks of having both the uterus and ovaries removed?
  3. What should women considering hysterectomy and salpingo-oophorectomy be made aware of?

Doctor’s Tip

One helpful tip a doctor might give a patient considering salpingo-oophorectomy is to discuss the potential benefits and risks with their healthcare provider before making a decision. It is important to weigh the reduced risk of breast cancer against the potential increased risk of other health issues, such as cardiovascular disease or osteoporosis, that can result from the removal of ovaries. Additionally, it is important for patients to discuss alternative options for managing their risk of breast cancer, such as increased surveillance or risk-reducing medications, before deciding on surgery. Ultimately, the decision to undergo salpingo-oophorectomy should be personalized based on each individual’s unique medical history and risk factors.

Suitable For

Salpingo-oophorectomy is typically recommended for patients with a high risk of developing ovarian or breast cancer, such as those with a strong family history of these cancers or those with known genetic mutations (such as BRCA1 or BRCA2 mutations). It may also be recommended for patients with certain gynecological conditions, such as ovarian cysts, endometriosis, or pelvic inflammatory disease. Additionally, salpingo-oophorectomy may be recommended as part of a hysterectomy for the treatment of uterine fibroids, abnormal uterine bleeding, or other gynecological conditions.

Timeline

Before the salpingo-oophorectomy:

  • Patient may undergo various tests and consultations with their healthcare provider to determine if the surgery is necessary
  • Patient may experience symptoms such as pelvic pain, abnormal bleeding, or ovarian cysts that warrant the surgery
  • Patient may discuss the potential risks and benefits of the surgery with their healthcare provider

After the salpingo-oophorectomy:

  • Patient may experience pain and discomfort in the surgical area, which can be managed with pain medication
  • Patient may need to stay in the hospital for a few days after the surgery for monitoring and recovery
  • Patient may experience menopausal symptoms such as hot flashes, night sweats, and mood swings due to the sudden decrease in estrogen levels
  • Patient may need hormone replacement therapy to manage menopausal symptoms and prevent long-term health risks associated with low estrogen levels
  • Patient may need to follow up with their healthcare provider regularly to monitor their overall health and well-being post-surgery.

What to Ask Your Doctor

  1. What are the specific reasons for recommending a salpingo-oophorectomy in my case?
  2. What are the potential benefits of having a salpingo-oophorectomy in terms of reducing my risk of breast cancer?
  3. What are the potential risks or complications associated with a salpingo-oophorectomy?
  4. Will removing my ovaries affect my hormone levels and potentially cause menopausal symptoms?
  5. How will a salpingo-oophorectomy impact my overall health and quality of life?
  6. Are there any alternative treatment options to consider instead of a salpingo-oophorectomy?
  7. How often will I need to follow up with you after the surgery for monitoring and care?
  8. What can I expect in terms of recovery time and potential limitations after a salpingo-oophorectomy?
  9. Are there any lifestyle changes or precautions I should take after undergoing a salpingo-oophorectomy?
  10. Can you provide me with more information or resources to help me make an informed decision about undergoing a salpingo-oophorectomy?

Reference

Authors: Chow S, Raine-Bennett T, Samant ND, Postlethwaite DA, Holzapfel M. Journal: Am J Obstet Gynecol. 2020 Dec;223(6):900.e1-900.e7. doi: 10.1016/j.ajog.2020.06.040. Epub 2020 Jun 23. PMID: 32585221