Should Women with BRCA Mutations be Offered Bilateral Salpingectomy with Delayed Oophorectomy for Ovarian Cancer Risk Reduction?

The fimbriated end of the fallopian tube plays a pivotal role in the pathogenesis of pelvic high-grade serous carcinomas (HGSC). While risk-reducing salpingo-oohprectomy (RRSO) is the standard of care for patients with genetic risk for developing HGSC, the detrimental effects of premature menopause on both health and quality of life are unacceptable to many patients. Risk-reducing early salpingectomy with delayed oophorectomy (RRESDO) has the potential to offer risk-reduction, without the toxicity of premature menopause and infertility. An individualized “previvorship” plan incorporating this option allows for patient-centered planning, with the potential for enhanced quality of life, earlier detection of precursor lesions, and possibly a greater impact in risk-reduction.