Our Summary

This study examined the factors that influence Japanese women with a genetic predisposition for breast and ovarian cancer to undergo a preventative procedure called risk-reducing salpingo-oophorectomy (removal of the ovaries and fallopian tubes). The researchers analyzed medical records from 157 women with this genetic risk from 2011-2021.

The findings showed that about 43% of the women decided to have the procedure, with the average age being 47. Factors that significantly influenced this decision were older age, being married, and having had children. Having a personal or family history of breast or ovarian cancer didn’t significantly affect the decision.

The study also found that the number of these preventative surgeries increased around 2016-2017 and again in 2020. The researchers suggest this may be related to Angelina Jolie’s publicized decision to undergo the same procedure in 2015, as well as the introduction of National Health Insurance coverage for the procedure in 2020.

Finally, the study found that about 4.5% of the women who had the procedure were found to have hidden cancers, which supports the recommendation for women with a genetic risk to consider this preventative surgery at a younger age. This is the first study to suggest possible influences of celebrity decisions and insurance changes on this health decision among Japanese women.

FAQs

  1. What factors influenced Japanese women with a genetic predisposition for breast and ovarian cancer to undergo risk-reducing salpingo-oophorectomy?
  2. How did Angelina Jolie’s decision to undergo salpingo-oophorectomy and the introduction of National Health Insurance coverage for the procedure in 2020 influence the number of these surgeries among Japanese women?
  3. What percentage of the women who had the salpingo-oophorectomy procedure were found to have hidden cancers and what is the implication of this finding?

Doctor’s Tip

A doctor might tell a patient considering salpingo-oophorectomy that it is important to consider the potential benefits of the surgery, such as reducing the risk of developing ovarian and breast cancer. They may also advise the patient to discuss their decision with their family and consider factors such as their age, marital status, and whether they have children. Additionally, the doctor may highlight the importance of regular screenings and genetic testing for those at risk for hereditary cancers.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those with a genetic predisposition for breast and ovarian cancer, such as BRCA1 or BRCA2 mutations. Other factors that may influence the recommendation for this procedure include a personal or family history of breast or ovarian cancer, older age, being married, and having had children. Additionally, patients who have been counseled on the risks and benefits of the surgery and understand the potential implications for their health may also be recommended for salpingo-oophorectomy.

Timeline

Before the salpingo-oophorectomy:

  • Women with a genetic predisposition for breast and ovarian cancer undergo genetic testing to determine their risk.
  • They may receive counseling and information about their options, including risk-reducing surgeries.
  • Factors like age, marital status, and family history may influence their decision to undergo the procedure.
  • The decision to undergo the surgery may be influenced by external factors such as media coverage and changes in insurance coverage.

After the salpingo-oophorectomy:

  • Women who decide to undergo the surgery will have their ovaries and fallopian tubes removed.
  • They may experience physical recovery and potential side effects of the surgery.
  • Pathology reports may reveal hidden cancers, highlighting the importance of early intervention for women at high risk.
  • Regular follow-up care and monitoring may be recommended to ensure the best possible outcomes for the patient’s health.

What to Ask Your Doctor

  1. What are the benefits of undergoing a salpingo-oophorectomy for someone with a genetic predisposition for breast and ovarian cancer?
  2. What are the potential risks or complications associated with this procedure?
  3. How will this surgery affect my hormone levels and menopausal symptoms?
  4. Are there any alternative risk-reducing strategies that I should consider?
  5. How often will I need to undergo follow-up screenings or monitoring after the surgery?
  6. What is the likelihood of finding hidden cancers during the surgery, and how will they be treated if found?
  7. How will this surgery impact my fertility and options for reproductive planning?
  8. Are there any specific lifestyle changes or precautions I should take after the surgery?
  9. How long is the recovery period after a salpingo-oophorectomy?
  10. Are there any specific support resources or counseling services available for individuals considering or undergoing this procedure?

Reference

Authors: Nagashima M, Ishikawa T, Asami Y, Hirose Y, Shimada K, Miyagami S, Mimura T, Miyamoto S, Onuki M, Morioka M, Izumi M, Yoshida R, Yamochi T, Taruno K, Nakamura S, Sekizawa A, Matsumoto K. Journal: Jpn J Clin Oncol. 2023 Jun 1;53(6):472-479. doi: 10.1093/jjco/hyad020. PMID: 36999211