Cancer Risk-Reducing Opportunities in Gynecologic Surgery

J Minim Invasive Gynecol. 2018 Nov-Dec;25(7):1179-1193. doi: 10.1016/j.jmig.2017.10.025. Epub 2017 Oct 31.

Abstract

This review article discusses cancer risk-reducing opportunities in gynecologic surgery. We cover strategies to reduce ovarian and uterine cancer risk by presenting general practice guidelines and expanding on the literature behind clinical decision points. We address populations of women at increased hereditary risk and those at population risk. We specifically discuss risk-reducing salpingo-oophorectomy, prophylactic salpingectomy with delayed oophorectomy, concomitant hysterectomy, opportunistic salpingectomy, bilateral tubal ligation, and hysterectomy. For clinical scenarios in which data are limited or conflicting, we detail the studies on which clinicians' decisions hinge to allow the reader to weigh the available evidence.

Keywords: BRCA; Hysterectomy; Lynch syndrome; Opportunistic; Prophylactic; Risk reducing; Risk-reducing salpingo-oophorectomy; Salpingo-oophorectomy.

Publication types

  • Review

MeSH terms

  • Feasibility Studies
  • Female
  • Genes, BRCA1
  • Genes, BRCA2
  • Genetic Predisposition to Disease
  • Hormone Replacement Therapy / methods
  • Humans
  • Hysterectomy / methods
  • Middle Aged
  • Mutation / genetics
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / prevention & control*
  • Ovarian Neoplasms / surgery
  • Patient Safety
  • Pedigree
  • Practice Patterns, Physicians'
  • Risk Factors
  • Salpingo-oophorectomy / methods*
  • Sterilization, Tubal / methods
  • Uterine Neoplasms / genetics
  • Uterine Neoplasms / prevention & control*
  • Uterine Neoplasms / surgery