Our Summary

In simpler terms, this research studied the long-term health effects of a specific surgery on women who have had breast cancer and carry certain genetic mutations (BRCA1 and BRCA2) that increase their risk of developing breast and ovarian cancers. The surgery, called bilateral salpingo-oophorectomy (BSO), involves removing both ovaries and fallopian tubes.

The researchers used data from the National Cancer Registration Dataset and genetic testing labs, focusing on women aged 20-75 years diagnosed with breast cancer between 1995 and 2019. They checked the outcomes for things like mortality, other types of cancer, cardiovascular diseases, and depression.

They found that the surgery was associated with a reduced risk of death from any cause and a lower risk of breast cancer-specific death for women with these genetic mutations. It also reduced the risk of developing a second, non-breast cancer. Importantly, having this surgery did not seem to increase the risk of cardiovascular diseases, depression, or other long-term negative health outcomes.

The study also found that fewer Black and Asian women had this surgery compared to White women, and women from less deprived areas were more likely to have it.

So, the study concludes that offering this surgery to women with these genetic mutations and a history of breast cancer seems to be beneficial and doesn’t lead to increased risk of other health problems.

FAQs

  1. What is bilateral salpingo-oophorectomy (BSO) surgery?
  2. What are the long-term health effects of BSO surgery on women with BRCA1 and BRCA2 genetic mutations who have had breast cancer?
  3. Does BSO surgery increase the risk of cardiovascular diseases, depression, or other long-term health outcomes?

Doctor’s Tip

A doctor might advise a patient considering salpingo-oophorectomy to discuss the potential benefits and risks with their healthcare provider. They may also recommend regular follow-up appointments to monitor overall health and well-being after the surgery. It is important for patients to be aware of the potential benefits of reducing the risk of certain cancers, while also understanding that there may be some long-term implications to consider.

Suitable For

These patients are typically recommended salpingo-oophorectomy:

  1. Women with BRCA1 and BRCA2 genetic mutations who have been diagnosed with breast cancer.
  2. Women at a high risk of developing ovarian cancer due to their genetic mutations.
  3. Women who have a family history of breast and ovarian cancers.
  4. Women who have completed childbearing and are looking to reduce their risk of developing ovarian and breast cancers.
  5. Women who have already had one ovary removed and are considering removing the other one to reduce their risk.

Overall, the surgery is recommended for women who are at a high risk of developing ovarian and breast cancers due to genetic mutations or family history. It is important for these patients to discuss the benefits and risks of the surgery with their healthcare provider to make an informed decision.

Timeline

  • Before salpingo-oophorectomy:
  1. Diagnosed with breast cancer and genetic mutations (BRCA1 and BRCA2).
  2. Consultation with healthcare provider to discuss treatment options.
  3. Decision to undergo bilateral salpingo-oophorectomy.
  4. Pre-operative testing and preparation for surgery.
  5. Surgery to remove both ovaries and fallopian tubes.
  • After salpingo-oophorectomy:
  1. Recovery period post-surgery.
  2. Follow-up appointments with healthcare provider to monitor healing and discuss any complications.
  3. Reduced risk of death from any cause and breast cancer-specific death.
  4. Lower risk of developing a second, non-breast cancer.
  5. No increased risk of cardiovascular diseases, depression, or other long-term negative health outcomes.
  6. Potential disparities in access to surgery based on race and socioeconomic status.
  7. Overall, the surgery is seen as beneficial in reducing cancer risk and improving long-term health outcomes for women with genetic mutations and a history of breast cancer.

What to Ask Your Doctor

Some questions a patient should ask their doctor about salpingo-oophorectomy include:

  1. Is salpingo-oophorectomy the best option for me based on my personal and family medical history?

  2. What are the potential benefits of undergoing a salpingo-oophorectomy in terms of reducing the risk of cancer and improving overall health outcomes?

  3. What are the potential risks and complications associated with salpingo-oophorectomy that I should be aware of?

  4. How will undergoing a salpingo-oophorectomy impact my hormone levels and menopausal symptoms?

  5. What is the recovery process like after undergoing a salpingo-oophorectomy and how long will it take to fully recover?

  6. Are there alternative treatments or risk-reducing strategies that I should consider instead of or in addition to salpingo-oophorectomy?

  7. How often will I need to follow up with you after undergoing a salpingo-oophorectomy to monitor my health and well-being?

  8. Will I need to take any medications or undergo additional screenings or tests after undergoing a salpingo-oophorectomy?

  9. How will undergoing a salpingo-oophorectomy impact my fertility and are there options available for preserving fertility before the surgery?

  10. Are there any specific lifestyle changes or precautions I should take after undergoing a salpingo-oophorectomy to maintain my overall health and well-being?

Reference

Authors: Hassan H, Allen I, Rahman T, Allen S, Knott C, Huntley C, Loong L, Garrett A, Walburga Y, Morris E, Hardy S, Torr B, McRonald F, Vernon S, Lüchtenborg M, Pethick J, Santaniello F, Goel S, Eccles DM, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Journal: Lancet Oncol. 2025 Jun;26(6):771-780. doi: 10.1016/S1470-2045(25)00156-1. Epub 2025 May 8. PMID: 40347974