Our Summary

This research paper looks at whether a certain surgery, known as risk-reducing bilateral salpingo-oophorectomy (RRBSO), affects the risk of breast cancer in Jewish Israeli women who have certain genetic mutations (BRCA pathogenic sequence variants). RRBSO is a procedure where the ovaries and fallopian tubes are removed to lower the risk of certain cancers.

In the study, they compared women who had the surgery with those who didn’t. They found that the surgery didn’t affect the overall rate of breast cancer in all the women with the genetic mutations. However, for the women with a specific mutation (BRCA2), the surgery was linked to a lower risk of breast cancer. The use of hormone replacement therapy, which is sometimes used after the surgery, didn’t seem to affect the risk of breast cancer.

So, the main takeaway is that this surgery may lower the risk of breast cancer for Jewish Israeli women with a specific genetic mutation (BRCA2).

FAQs

  1. What is risk-reducing bilateral salpingo-oophorectomy (RRBSO)?
  2. How does RRBSO affect the risk of breast cancer in Jewish Israeli women with BRCA genetic mutations?
  3. Does the use of hormone replacement therapy after RRBSO surgery affect the risk of breast cancer?

Doctor’s Tip

A doctor might advise a patient considering salpingo-oophorectomy to discuss the potential benefits and risks of the surgery, including the potential impact on breast cancer risk based on their individual genetic profile. They may also recommend regular follow-up screenings and discussions about hormone replacement therapy post-surgery.

Suitable For

Patients who are typically recommended salpingo-oophorectomy are those who have a high risk of developing ovarian or breast cancer due to genetic mutations such as BRCA1 or BRCA2. This includes women with a family history of these cancers, a personal history of breast or ovarian cancer, or a known genetic mutation that increases their risk. Additionally, patients with certain gynecologic conditions, such as ovarian cysts or tumors, may also be recommended for this surgery. Ultimately, the decision to undergo salpingo-oophorectomy is made on a case-by-case basis by a healthcare provider after considering the patient’s individual risk factors and medical history.

Timeline

Before the surgery:

  • Patient undergoes genetic testing to determine if they have BRCA pathogenic sequence variants
  • Patient discusses the option of RRBSO with their healthcare provider
  • Patient may undergo counseling to understand the risks and benefits of the surgery

During the surgery:

  • Ovaries and fallopian tubes are removed in a surgical procedure

After the surgery:

  • Patient may experience temporary side effects such as pain, swelling, and fatigue
  • Patient may need to take hormone replacement therapy to manage menopausal symptoms
  • Patient undergoes regular follow-up appointments to monitor for any complications or recurrence of cancer
  • In the case of the study mentioned, the patient may have a lower risk of breast cancer, especially if they have the BRCA2 mutation

What to Ask Your Doctor

  1. What is the purpose of a salpingo-oophorectomy and how does it reduce the risk of certain cancers?
  2. Am I a candidate for a risk-reducing bilateral salpingo-oophorectomy based on my family history and genetic testing results?
  3. What are the potential risks and complications associated with this surgery?
  4. How will this surgery impact my hormone levels and menopausal symptoms?
  5. Is hormone replacement therapy recommended after this surgery, and if so, what are the benefits and risks?
  6. How often will I need to follow up with my healthcare provider after the surgery?
  7. Are there any lifestyle changes or additional screenings I should consider after undergoing this surgery?
  8. Are there any alternative risk-reducing options I should consider before deciding on a salpingo-oophorectomy?
  9. How will this surgery affect my fertility and options for preserving fertility?
  10. Can you provide me with more information about the specific genetic mutation (BRCA2) that may impact my risk of breast cancer and the effectiveness of this surgery in reducing that risk?

Reference

Authors: Perri T, Levin G, Naor-Revel S, Eliassi-Revivo P, Lifshitz D, Friedman E, Korach J. Journal: Int J Gynaecol Obstet. 2022 May;157(2):431-436. doi: 10.1002/ijgo.13843. Epub 2021 Aug 18. PMID: 34324701