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Ovarian Cancer After Prophylactic Salpingectomy in a Patient With Germline BRCA1 Mutation
Nicole Lugo Santiago1, Evan Smith, Mary Cox
1Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Atlantic Health System, Morristown, New Jersey; Obafemi Awolowo University, Ile-Ife, Nigeria; and the Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York.
Background:
Women with germline BRCA1 or BRCA2 mutations have a lifetime risk of ovarian cancer of up to 46%. Opportunistic salpingectomy has been advocated as a risk-reducing strategy owing to increasing recognition of tubal origin, yet evidence of efficacy in this high-risk population is limited.
Case:
This is the case of a woman with a BRCA1 mutation who underwent prophylactic mastectomy and bilateral salpingectomy with ovarian retention before the age of 40 years. She did not undergo oophorectomy and subsequently developed stage IV high-grade serous ovarian cancer 4 years after her initial surgery.
Conclusion:
More research is needed to determine the role of prophylactic salpingectomy with delayed oophorectomy, optimal timing of completion oophorectomy, and the risks and benefits compared with up-front risk-reducing salpingo-oophorectomy.
