Risk of Peritoneal Cancer After Risk-Reducing Bilateral Salpingo-Oophorectomy for Women
The average lifetime risk of developing ovarian cancer risk for women who harbor a BRCA1 or BRCA2 pathogenic germline mutation is 44% and 17%, accordingly, compared with 1.3% for the general population. Most ovarian cancer are high-grade serous cancers that primarily originate from a serous tubal intraepithelial carcinoma (the precursor of pelvic serous carcinomas and the earliest malignant alteration in BRCA mutation-positive women) within the fallopian tube.
For most women, the risk of epithelial ovarian cancer does not begin to increase until they reach approximately 35 years of age in those with a BRCA1 mutation.
For most women, the risk of epithelial ovarian cancer does not begin to increase until they reach approximately 35 years of age in those with a BRCA1 mutation and closer to age 50 years for those women with a BRCA2 mutation. A prophylactic salpingo-oophorectomy (a surgical procedure to remove both ovaries and the fallopian tubes) decreases this risk dramatically and is associated with a reduction in ovarian cancer–specific mortality; the surgery is indicated for women ages 35-40 years and 40-45 years for a BRCA1 and BRCA2 mutation, respectively. However, there is a small residual risk (1%-4%) for peritoneal carcinomatosis (a condition wherein the cancer spreads throughout the abdominal cavity), an outcome which can be challenging to treat and should be discussed with the treating physician.
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