Reply to prophylactic salpingo-oophorectomy in a series of 89 women carrying a BRCA1 or a BRCA2 mutation

✍ Scribed by Fatima Laki; Remy Salmon; Dominique Stoppa-Lyonnet

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 30 KB
• Volume: 110
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/cncr.23103

✦ Synopsis

Prophylactic Salpingo-Oophorectomy in a Series of 89 Women Carrying a BRCA1 or a BRCA2 Mutation I read with great interest the article published in Cancer by Laki et al. 1 and strongly support that prophylactic salpingo-oophorectomy (SO) is an important option for BRCA1/2 mutation carriers, as asymptomatic ovarian/fallopian cancers are found in 4.5% of patients.

In developing countries, especially in low-resource settings, a facility for detection of BRCA1 or a BRCA2 mutation is not available. In this situation it becomes very difficult to decide on prophylactic SO, so we do not routinely perform it. If there is any family history of breast or gynecological cancer in first-degree relatives and the woman is undergoing hysterectomy for reasons other than malignancy, we offer them the option of prophylactic SO. It is important to counsel the patient about the risk of ovarian pathology and the lack of absolutely reliable preoperative or intraoperative predictors to guide decision-making. Also, it should be explained in advance that surgical castration induces an abrupt loss of estrogen, which causes climacteric symptoms, especially hot flushes, sleep disorders, and long-term effects, which include a deleterious impact on cardiovascular and bone health in addition to the loss of fertility.