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Ovarian Risk Reduction Surgery

Research and Clinical Trials for Ovarial Risk Reduction Surgery

A considerable amount of recent research has shown that ovarian risk reduction surgery significantly decreases an at-risk woman’s chances of developing ovarian and (to a lesser extent) breast cancer, compared to at-risk women who chose frequent exams and testing rather than surgery. For example:

  • One study used registries of women with BRCA mutations, and identified 259 women who had undergone surgery and 292 who had not. These women were then tracked for eight years. While only two women in the surgery group had developed primary peritoneal cancer—a cancer that resembles ovarian cancer—58 women in the non-surgery group were diagnosed with ovarian cancer. In addition, doctors found early-stage ovarian cancer in six women who underwent surgery.
  • A similar study tracked 218 women with BRCA mutations for about four years. Of the 73 women who declined surgery and chose instead to closely monitor and test for cancer, eight were diagnosed with peritoneal or ovarian cancer, and 14 were diagnosed with breast cancer. Of the 145 women in the surgery group, meanwhile, two developed peritoneal cancer and five developed breast cancer. Doctors found early-stage ovarian cancer in three women who had surgery.

The long-term picture is a little more complicated, however. A 2006 study found that women who had undergone bilateral oophorectomy before the age of 45—and especially those who had not received estrogen through the age of 45—had a higher risk of dying from causes such as heart disease, stroke, hip fracture and cancer than those who had not had the surgery. A 2007 study found that for women with an average chance of developing ovarian cancer, not having an oophorectomy until age 65 was beneficial for their long-term survival.

As the researchers note, it’s not clear if the surgery itself (or the lack of estrogen in the woman’s body that it produces) is the cause of the increased mortality or if having the surgery simply indicates a woman has a greater chance of developing these other problems.