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Risk-reducing bilateral salpingo-oophorectomy in women at high risk of epithelial ovarian and fallopian tubal cancer

Michael G Muto, MD
Section Editor
Barbara Goff, MD
Deputy Editor
Sandy J Falk, MD, FACOG


Risk-reducing bilateral salpingo-oophorectomy (rrBSO) is an important option for decreasing the risk of epithelial ovarian and fallopian tubal cancer in women who have the highest likelihood of developing this malignancy [1]. Other preventive measures and surveillance measures are available, but are of limited efficacy in reducing the high rates of cancer mortality.

Emerging data suggest that some apparent ovarian cancers, particularly in women with BRCA gene mutations, are initiated in the fallopian tubes, thus, risk-reducing surgery must include bilateral removal of the tubes as well as the ovaries [2].

In addition, women with a hereditary ovarian cancer syndrome may also be at risk for other malignancies, including breast and peritoneal cancer in BRCA gene mutation carriers and endometrial or colon cancer in those with Lynch syndrome (hereditary nonpolyposis colorectal cancer) [3]. Decisions regarding various cancer risk reduction must take into account prevention or surveillance of these other tumors.

rrBSO results in sterility and surgical menopause. Patients must be counseled about these implications of this procedure and alternative reproductive and hormone therapy options [4].

rrBSO as a strategy to prevent ovarian and fallopian tubal cancer in high-risk women will be reviewed here. Elective oophorectomy or salpingectomy at the time of hysterectomy in women at average risk of ovarian cancer and strategies to reduce breast cancer or endometrial cancer in women with hereditary cancer syndromes are discussed separately. (See "Elective oophorectomy or ovarian conservation at the time of hysterectomy" and "Management of patients at high risk for breast and ovarian cancer" and "Endometrial and ovarian cancer screening and prevention in women with Lynch syndrome (hereditary nonpolyposis colorectal cancer)".)

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Literature review current through: Nov 2017. | This topic last updated: Jul 07, 2017.
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