Risk Reducing Surgery

Risk reducing surgery involves bilateral salpingo-oophorectomy, which is the surgical removal of the ovaries and fallopian tubes. It may also include removal of the uterus (hysterectomy). It is an important option for decreasing the risk of ovarian and fallopian tube cancers in women who are at high risk of developing these malignancies.

A hysterectomy, in addition to removal of the ovaries and fallopian tubes, is recommended for women with Lynch Syndrome.

Risk Factors

Women who may be are at risk of developing ovarian cancer are those who are known to carry an inherited gene mutation, such as BRCA1, BRCA2, Lynch Syndrome (also known as hereditary non-polyposis colorectal cancer), and other syndromes. Women with a strong family history of ovarian cancer or a personal history of breast cancer, in the absence of a known mutation, may also be at increased risk and may benefit from risk reducing surgery after appropriate review.

More information here on genetic counselling and testing.

Alternatives to Surgery

Other preventive and surveillance strategies are available such as regular pelvic ultrasound scans and blood tests for the tumour marker CA125. Unfortunately, these are of limited value in detecting cancer at an early, curable stage and not recommended.

More information here on population screening and early detection of ovarian cancer in asymptomatic women.

Risk Reducing Surgery Method

Our gynaecologic oncologist almost always performs risk reducing bilateral salpingo-oophorectomy and hysterectomy via a laparoscopic (keyhole) approach. It is usually recommended that a certified gynaecologic oncologist perform the surgery as cancer may already be present in up to 7% of the cases. Furthermore, the whole segment of the fallopian tube and an extra segment of blood vessel proximal to the ovary must be removed. Pelvic washings and biopsies of any suspicious areas are also required.

More information here on laparoscopy.

Consequences of Risk Reducing Surgery

Risk reducing bilateral salpingo-oophorectomy will result in surgical menopause and loss of fertility. Before a final decision is made to proceed with risk reducing surgery, the patient may discuss these implications with our women health’s general physician or gynaecologists.

More information here on menopause management.

Our Services / Gynaecologic Oncology