Current Situation and Future Directions of Risk-reducing          Salpingo-oophorectomy

Kenta Masuda; Yusuke Kobayashi; Tomoko Seki; Tomoko Yoshihama; Kohei Nakamura; Yumiko Goto; Mamiko Yamada; Aiko Nagayama; Sayaka Uchida; Ikumi Ono; Kumiko Misu; Megumi Yokota; Wataru Yamagami

doi:10.2302/kjm.2024-0024-RE

Current Situation and Future Directions of Risk-reducing Salpingo-oophorectomy

Kenta Masuda , Yusuke Kobayashi, Tomoko Seki, Tomoko Yoshihama, Kohei Nakamura, Yumiko Goto, Mamiko Yamada, Aiko Nagayama, Sayaka Uchida, Ikumi Ono, Kumiko Misu, Megumi Yokota, Wataru Yamagami

Author information

Kenta Masuda Corresponding author
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Yusuke Kobayashi
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Tomoko Seki
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Department of Surgery, Keio University School of Medicine, Tokyo, Japan
Tomoko Yoshihama
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Kohei Nakamura
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Center for Cancer Genomics, Keio University School of Medicine, Tokyo, Japan
Yumiko Goto
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
Mamiko Yamada
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Aiko Nagayama
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Department of Surgery, Keio University School of Medicine, Tokyo, Japan
Sayaka Uchida
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Ikumi Ono
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Kumiko Misu
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
Megumi Yokota
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan
Wataru Yamagami
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
Center for Hereditary Breast and Ovarian Cancer Syndrome, Keio University Hospital, Tokyo, Japan

Keywords: BRCA1/2, HBOC, risk-reducing salpingo-oophorectomy, prophylactic salpingectomy with delayed oophorectomy, hormone replacement therapy

JOURNAL FREE ACCESS FULL-TEXT HTML Advance online publication

Article ID: 2024-0024-RE

DOI https://doi.org/10.2302/kjm.2024-0024-RE

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Abstract

High-grade serous carcinoma (HGSC), the most aggressive subtype of epithelial ovarian cancer, is strongly associated with hereditary breast and ovarian cancer (HBOC) syndrome and is primarily linked to germline BRCA1/2 pathogenic variants (PVs). The cumulative risks of ovarian cancer by the age of 70 years are 40% and 18% for carriers of BRCA1 and BRCA2 PVs, respectively. Risk-reducing salpingo-oophorectomy (RRSO) is a recommended preventive strategy that reduces the risk of ovarian cancer by more than 80% and may improve overall survival. However, surgical menopause after RRSO poses several challenges, including infertility and hormonal deficiency. Although the use of hormone replacement therapy may alleviate symptoms, it requires careful consideration of breast cancer risk. Emerging strategies, such as prophylactic salpingectomy with delayed oophorectomy, are being investigated to balance cancer prevention and patient quality of life. Further research is required to refine personalized prevention and management approaches for HBOC-associated ovarian cancer.

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