Our Summary

This study looked at women who carry a BRCA1/2 genetic variant, which increases their risk of developing ovarian cancer. The current preventative measure for these women is a surgery called risk-reducing salpingo-oophorectomy (RRSO), which removes the ovaries and fallopian tubes but also leads to early menopause. This study examined a new approach: removing only the fallopian tubes first (which are believed to play a key role in developing ovarian cancer) and delaying the removal of the ovaries, aiming to postpone menopause.

The study found that this new approach resulted in a better quality of life related to menopause than the current surgery, whether or not the women were given hormone replacement therapy. The study is now looking at whether this new approach is as effective at preventing cancer as the current surgery.

FAQs

  1. What is the current preventative measure for women with a BRCA1/2 genetic variant?
  2. What is the new approach to surgery being studied to prevent ovarian cancer in women with the BRCA1/2 variant?
  3. Did the new approach improve the quality of life related to menopause in comparison to the current surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about salpingo-oophorectomy is to consider discussing with their healthcare provider the option of removing only the fallopian tubes first and delaying the removal of the ovaries in order to potentially postpone menopause and improve quality of life. It’s important to weigh the potential benefits and risks of this new approach compared to the traditional surgery, especially for women with a BRCA1/2 genetic variant. Additionally, it’s crucial to stay informed and discuss all options with a healthcare provider to make the best decision for individual health needs.

Suitable For

Typically, patients who are recommended salpingo-oophorectomy are women who carry a BRCA1/2 genetic variant, which increases their risk of developing ovarian cancer. These women may opt for risk-reducing salpingo-oophorectomy (RRSO) as a preventative measure to reduce their risk of developing ovarian cancer.

Timeline

Before the salpingo-oophorectomy:

  • Patient undergoes genetic testing to determine if they carry a BRCA1/2 genetic variant
  • Patient receives counseling on their risk of developing ovarian cancer
  • Patient decides to undergo risk-reducing salpingo-oophorectomy
  • Patient undergoes surgery to remove ovaries and fallopian tubes

After the salpingo-oophorectomy:

  • Patient experiences early menopause symptoms such as hot flashes, mood swings, and vaginal dryness
  • Patient may be prescribed hormone replacement therapy to manage menopausal symptoms
  • Patient may have follow-up appointments to monitor their health and adjust hormone replacement therapy as needed
  • Patient may undergo additional screenings or preventive measures to monitor for any signs of cancer recurrence

With the new approach of removing only the fallopian tubes:

  • Patient undergoes surgery to remove fallopian tubes only
  • Patient experiences a lesser impact on menopausal symptoms compared to traditional salpingo-oophorectomy
  • Patient may have a longer period of time before experiencing menopause
  • Patient may have a reduced risk of developing ovarian cancer compared to traditional surgery
  • Further research is ongoing to determine the effectiveness of this new approach in preventing cancer and maintaining quality of life.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a salpingo-oophorectomy for women with a BRCA1/2 genetic variant?

  2. How does removing only the fallopian tubes first and delaying the removal of the ovaries affect the risk of developing ovarian cancer compared to traditional RRSO?

  3. What are the potential implications for fertility and menopause with this new approach compared to traditional RRSO?

  4. What are the long-term effects of delaying the removal of the ovaries in terms of cancer prevention and overall health outcomes?

  5. Are there any alternative options or treatments available for reducing the risk of ovarian cancer for women with a BRCA1/2 genetic variant?

  6. How will hormone replacement therapy be managed for women undergoing this new approach to minimize the effects of early menopause?

  7. What follow-up care and monitoring will be necessary after undergoing this new approach to assess its effectiveness in preventing ovarian cancer?

  8. Are there any specific lifestyle changes or precautions that should be taken after undergoing this new approach for reducing the risk of cancer or managing menopausal symptoms?

  9. What is the success rate of this new approach compared to traditional RRSO in terms of preventing ovarian cancer and improving quality of life for women with a BRCA1/2 genetic variant?

  10. What are the potential financial implications or insurance coverage for undergoing this new approach compared to traditional RRSO?

Reference

Authors: Steenbeek MP, Harmsen MG, Hoogerbrugge N, de Jong MA, Maas AHEM, Prins JB, Bulten J, Teerenstra S, van Bommel MHD, van Doorn HC, Mourits MJE, van Beurden M, Zweemer RP, Gaarenstroom KN, Slangen BFM, Brood-van Zanten MMA, Vos MC, Piek JMJ, van Lonkhuijzen LRCW, Apperloo MJA, Coppus SFPJ, Massuger LFAG, IntHout J, Hermens RPMG, de Hullu JA. Journal: JAMA Oncol. 2021 Aug 1;7(8):1203-1212. doi: 10.1001/jamaoncol.2021.1590. PMID: 34081085