Our Summary

This study looked at the surgical procedures used to help prevent the chance of ovarian cancer in women who have a higher risk due to genetic factors. This operation, known as bilateral salpingo-oophorectomy, involves removing both ovaries and fallopian tubes. Specific guidelines have been set out by medical organizations for how this surgery should be done for the best results.

The researchers wanted to see how closely these guidelines were being followed by two different types of doctors: specialists in women’s cancer (gynecologic oncologists) and general women’s health doctors (gynecologists). They also wanted to see if there were any differences in the rates of hidden cancer found during the surgery between these two types of doctors.

They reviewed the medical records of 185 patients who had this surgery between 2015 and 2020. They found that the cancer specialists were more likely to follow all the recommended steps for the surgery. However, there was no significant difference in how the two types of doctors followed the guidelines for examining the removed tissues for signs of cancer.

Interestingly, all the cases where hidden cancer was found during surgery were performed by general gynecologists, not the specialists. The researchers suggest that more education and standardization are needed to ensure that all doctors are following the best practices for this preventative surgery.

FAQs

  1. What is a bilateral salpingo-oophorectomy and why is it performed?
  2. What were the major findings of the study on the performance of bilateral salpingo-oophorectomy by different types of doctors?
  3. What recommendations did the researchers make to improve the outcomes of preventative bilateral salpingo-oophorectomy procedures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about salpingo-oophorectomy is to make sure to choose a doctor who is experienced and follows the recommended guidelines for the surgery. It is important to discuss the risks and benefits of the procedure with your doctor and ask any questions you may have. Additionally, it is important to follow up with regular screenings and check-ups after the surgery to monitor for any signs of cancer.

Suitable For

Patients who are typically recommended for salpingo-oophorectomy include those with a high risk of developing ovarian cancer due to genetic factors, such as a family history of ovarian or breast cancer, or carrying certain genetic mutations like BRCA1 or BRCA2. Additionally, patients with a personal history of breast cancer or other factors that increase their risk of 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 the right option for them.

Timeline

Before the salpingo-oophorectomy:

  1. Patient undergoes genetic testing to determine if they have an increased risk of ovarian cancer.
  2. Patient discusses options with their healthcare provider, including the possibility of a salpingo-oophorectomy.
  3. Patient receives counseling and information about the procedure, risks, and benefits.
  4. Patient schedules the surgery and undergoes pre-operative testing.

After the salpingo-oophorectomy:

  1. Patient undergoes the surgical procedure to remove both ovaries and fallopian tubes.
  2. Patient is monitored closely in the hospital for any complications.
  3. Patient is discharged from the hospital and recovery at home begins.
  4. Patient may experience symptoms such as pain, discomfort, and fatigue during the recovery period.
  5. Patient follows up with their healthcare provider for post-operative care and monitoring.
  6. Patient may experience changes in hormone levels and potential long-term effects of the surgery, such as early menopause.
  7. Patient continues to receive regular screenings and follow-up care to monitor for any signs of cancer recurrence.

What to Ask Your Doctor

  1. What are the specific guidelines for undergoing a bilateral salpingo-oophorectomy?
  2. What are the risks and benefits of undergoing this surgery?
  3. What are the potential long-term effects of having both ovaries and fallopian tubes removed?
  4. How will this surgery affect my fertility and menopausal symptoms?
  5. What is the likelihood of finding hidden cancer during the surgery?
  6. What steps will be taken to examine the removed tissues for signs of cancer?
  7. Are there any alternative options or treatments available for reducing the risk of ovarian cancer?
  8. How often will I need to follow up with my doctor after the surgery?
  9. What is the experience and expertise of the doctor who will be performing the surgery?
  10. Are there any specific precautions or lifestyle changes I should take before and after the surgery?

Reference

Authors: Blustein P, Werner SR, Uppalapati P, Leung TM, Husk GA, Pereira EB, Whyte JS, Villella JA. Journal: Am J Obstet Gynecol. 2023 Sep;229(3):280.e1-280.e8. doi: 10.1016/j.ajog.2023.06.011. Epub 2023 Jun 10. PMID: 37308046