Our Summary

This study looked at a large group of patients with a specific genetic mutation (BRCA) which increases their risk of developing ovarian cancer. The researchers wanted to see how often ovarian cancer was found when these patients had a preventative surgical procedure, called a bilateral salpingo-oophorectomy, where both ovaries and fallopian tubes are removed to reduce the risk of developing cancer. They also wanted to see if the surgery was being performed according to the guidelines recommended by the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncology.

The research found that ovarian cancer was found in a very small number of these surgeries, and often it was not detected during the surgery because the cancer was still microscopic. The study also found that some of the recommended practices for this procedure were not always followed when the surgery was performed by general gynecologists rather than specialist gynecologic oncologists.

The researchers concluded that while there is no need for only specialist gynecologic oncologists to perform these surgeries, there is a need to ensure that all gynecologists follow the recommended practices for this preventative procedure.

FAQs

  1. What is the purpose of a bilateral salpingo-oophorectomy?
  2. What was the primary finding of the study regarding the occurrence of ovarian cancer in patients who underwent the procedure?
  3. Did the study find that the recommended practices for a bilateral salpingo-oophorectomy were always followed?

Doctor’s Tip

A doctor might advise a patient considering a salpingo-oophorectomy to seek out a gynecologic oncologist for the procedure, as they are specialists in this type of surgery and are more likely to follow recommended practices to ensure the best possible outcome. Additionally, the doctor may recommend discussing the risks and benefits of the surgery thoroughly with the patient to ensure they are fully informed before making a decision.

Suitable For

Patients who are typically recommended for salpingo-oophorectomy include those with a genetic mutation (such as BRCA) that increases their risk of developing ovarian cancer, as well as those with a strong family history of ovarian or breast cancer. Additionally, patients who have completed childbearing and are at high risk for developing ovarian cancer may also be recommended for this surgery. It is important for patients to discuss their individual risk factors with their healthcare provider to determine if salpingo-oophorectomy is appropriate for them.

Timeline

Before the salpingo-oophorectomy:

  • Patient may undergo genetic testing to determine if they have a BRCA mutation
  • Patient may receive counseling on their risk of developing ovarian cancer
  • Patient may discuss with their healthcare provider about the option of having a preventative bilateral salpingo-oophorectomy
  • Patient may undergo pre-operative testing and evaluation to ensure they are a suitable candidate for surgery

After the salpingo-oophorectomy:

  • Patient will have their ovaries and fallopian tubes removed to reduce their risk of developing ovarian cancer
  • Patient may experience some pain and discomfort post-surgery
  • Patient will have follow-up appointments with their healthcare provider to monitor their recovery and overall health
  • Patient may experience menopausal symptoms due to the removal of their ovaries
  • Patient will have a reduced risk of developing ovarian cancer in the future, but will still need to undergo regular screenings for other types of cancer as recommended by their healthcare provider.

What to Ask Your Doctor

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

  1. What are the benefits of undergoing a bilateral salpingo-oophorectomy for someone with a genetic mutation like BRCA?
  2. What are the potential risks and complications associated with this surgery?
  3. How often should I have follow-up screenings or tests after the surgery?
  4. Will removing my ovaries and fallopian tubes affect my hormone levels or menopausal symptoms?
  5. Are there alternative options for reducing my risk of ovarian cancer, and how do they compare to surgery?
  6. What is the recovery process like after a bilateral salpingo-oophorectomy?
  7. How often should I see a specialist for ongoing monitoring and care after the surgery?
  8. How often should I have genetic counseling or testing to assess my risk for other types of cancer?
  9. What factors determine whether the surgery should be performed by a general gynecologist or a specialist gynecologic oncologist?
  10. Are there any specific guidelines or recommendations I should be aware of before undergoing this surgery?

Reference

Authors: Newcomb LK, Toal CT, Rindos NB, Wang L, Mansuria SM. Journal: J Minim Invasive Gynecol. 2020 Nov-Dec;27(7):1511-1515. doi: 10.1016/j.jmig.2020.01.004. Epub 2020 Jan 9. PMID: 31927044