Ovarian cancer leads to more deaths than all other gynecologic cancers combined. In the general population, the risk of ovarian cancer is 1.4%. In contrast, a woman with a deleterious BRCA1 gene mutation has a 30% to 40% chance of developing ovarian

Table 4-5. Ovarian Cancer Risk Reduction: Surgery in Women with BRCA Mutations

Investigation Surgery Odds Ratio 95% CI

Rebbeck et al24 Prophylactic BSO 0.04 0.01-0.16

Kauff et al25 Prophylactic BSO 0.15 0.02-1.31

Rutter et al26 Prophylactic BSO 0.29 0.12-0.73

Rutter et al26 BTL/hysterectomy 0.67 0.38-1.18

BSO, bilateral salpingo-oophorectomy; BTL, bilateral tubal ligation.

Table 4-6. Summary of Ovarian Cancer Risk Reduction

Intervention Odds Ratio


Oral contraceptives general population Oral contraceptives high-risk population Prophylactic BSO general population Prophylactic BSO high-risk population BTL/hysterectomy general population BTL/hysterectomy high-risk population

BSO, bilateral salpingo-oophorectomy; BTL, bilateral tubal ligation. Data from references 5, 15, 19, 20, 24, 26.

300 surgeries to prevent 1 case


cancer in her lifetime. Currently, an effective screening test for ovarian cancer is not available. Chemoprevention for ovarian cancer with oral contraceptive pills appears to be beneficial in both the general population and in women with a high risk of ovarian cancer. Prophylactic oophorectomy has only a modest impact on reducing ovarian cancer rates in the general population. In contrast, bilateral salpingo-oophorectomy in the high-risk group significantly decreases the risk of developing an ovarian malignancy. For patients who are unfortunately found to have occult cancers at the time of this surgery, this procedure most likely represents intervention at an earlier stage than would be expected. Although prophylactic surgery may be effective in the high-risk group, it does result in surgical menopause. Improvements in screening and chemoprevention would be welcomed.

Was this article helpful?

0 0
10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook

Post a comment