2026 Volume 53 Issue 3 Pages 185-191
Risk-reducing salpingo-oophorectomy (RRSO) is recommended in clinical guidelines as primary prevention for hereditary breast and ovarian cancer (HBOC). In contrast, transvaginal ultrasonography (TVUS) as surveillance for patients who decline or defer RRSO lacks established evidence for reducing mortality and is only “considered” in guidelines. TVUS, however, is minimally invasive, immediately available, and can promptly provide morphologic information such as mural nodules, solid components, and Doppler flow.
We herein report a patient with HBOC receiving neoadjuvant chemotherapy for breast cancer in whom TVUS, performed after genetic counseling, detected a right adnexal mass. This led to expedited evaluation and surgical management. Histopathology revealed ovarian clear cell carcinoma, staged as FIGO IC1 owing to minor intraoperative spill. Breast cancer therapy was subsequently resumed, and no residual invasive disease was identified.
This article is not intended to support universal screening with TVUS in women who have not undergone RRSO. However, in individuals referred to gynecologic care following a genetic diagnosis, the selective use of TVUS according to the clinical context may facilitate earlier detection and more timely referral to specialized care.
