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Prophylactic bilateral salpingo-oophorectomy is the best strategy for reducing the risk of ovarian cancer in BRCA-positive women, notes Warner K. Huh, MD. Risk is reduced by over 90% in high-risk individuals, adds Robert A. Burger, MD. However, the reduction in risk of ovarian cancer is accompanied by early menopause, and women should receive appropriate counseling, remarks Huh.
Burger comments that treatments (eg, hormone replacement therapy) are available to address symptoms of menopause. Patients receiving hormone therapy should be monitored appropriately; there is no evidence an increased risk of metabolic or other lifelong medical consequences of hormone replacement with careful monitoring.
Due to the increased risk of breast cancer associated with these genetic abnormalities, patients who undergo oophorectomy and receive hormone replacement therapy may also require prophylactic mastectomies, notes Michael J. Birrer, MD.
James Tate Thigpen, MD, highlights the importance of educating patients that the risk for the development of ovarian cancer does not drop to zero after oophorectomy, as ovarian neoplasms can arise elsewhere in the abdominal cavity.