Prophylactic Removal of Ovaries

Bilateral salpingo-oophorectomy” [BSO] refers to the surgical removal of both ovaries and both tubes. In women at increased risk for ovarian cancer, bilateral prophylactic oophorectomy has been shown to be a highly effective tool to lower the risk for both ovarian cancer and breast cancer. 

“Risk-reducing oophorectomy” refers to the removal of healthy ovaries in women who have an elevated risk for ovarian cancer. Women with elevated hereditary risk for ovarian cancer also have an elevated risk for fallopian tube cancer. For this reason, when their ovaries are removed prophylactically, the fallopian tubes must also be removed.

Current expert guidelines recommend that women with hereditary risk of breast and ovarian cancers [BRCA mutations] should undergo bilateral BSO between the ages of 35 - 40 or after childbearing is completed. This surgery has been shown through research to improve survival in mutation carriers.

The risk factors of ovarian cancer is associated with the following: 

  • Low parity
  • Infertility
  • Never taking oral contraceptive pill
  • Age > 50
  • BRCA1 and BRCA2 carriers carry 15 to 60% lifetime risk of ovarian cancer and high risk of breast cancer
  • Family history of either ovarian or breast cancer- especially multiple affected members at early age.

However, the surgery also causes immediate surgical menopause, which can be accompanied by short and long-term side effects and health consequences.