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Effectiveness of Risk-Reducing Salpingo-Oophorectomy in Preventing Ovarian Cancer in a High-Risk French Canadian Population

Bacha, Omar Moreira MD*; Gregoire, Jean MD; Grondin, Katherine MD; Edelweiss, Maria Isabel MD, PhD*; Laframboise, Rachel MD§; Simard, Jacques PhD§; Plante, Marie MD

International Journal of Gynecological Cancer: July 2012 - Volume 22 - Issue 6 - p 974–978
doi: 10.1097/IGC.0b013e318257b936
Ovarian Cancer

Background: Women with germ line BRCA1 or BRCA2 mutations have a marked increased risk of breast and ovarian cancer compared with the general population, whereas risk-reducing salpingo-oophorectomy (RRSO) significantly lowers the incidence of these cancers. The objective of this study was to review the clinical and pathological characteristics of a French Canadian population undergoing RRSO. Surgical morbidity was also evaluated.

Materials and Methods: From December 1999 to December 2009, all women who underwent RRSO at our institution were identified. Medical records were retrospectively reviewed. Descriptive statistics, the Fischer exact test, and the Student t test were used for analysis.

Results: During the study period, RRSO was performed on 119 women. Mean age at surgery was 49 years (35–72 years), and 63 patients (53%) were premenopausal. Sixty-two women (52%) had a history of in situ or invasive breast cancer. BRCA1 and BRCA2 mutations were present in 34 patients (29%) and 42 patients (35%), respectively, whereas 43 patients (36%) were considered to have an increased risk of breast and ovarian cancer, despite a personal genetic test, which was either negative (n = 23) or unknown because the patient declined genetic testing (n = 20). Most patients with a uterus in place had a complementary hysterectomy (65%). Six complications occurred (3 hematomas, 2 cardiac arrhythmias, and 1 cystotomy). In one patient (0.8%), a high-grade stage II ovarian cancer was discovered at the time of surgery. Fallopian tube atypias were identified on final pathology in 8 cases (6.7%). After a median follow-up of 22 months, 4 women (3.4%) developed breast cancer and one woman (0.8%) developed peritoneal cancer.

Conclusions: Risk-reducing salpingo-oophorectomy is highly effective in preventing ovarian, fallopian tube, and breast cancers in a high-risk French Canadian population; and the surgical morbidity is low.

*Hospital de Clínicas de Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS); †Gynecologic Oncology Division, Centre Hospitalier Universitaire de Québec (CHUQ), L’Hôtel-Dieu de Québec, Laval University, ‡Pathology Department, Centre Hospitalier Universitaire de Québec (CHUQ), L’Hôtel-Dieu de Québec, Laval University, and §Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec (CHUQ) Research Center and Department of Molecular Medicine, Laval University. Laboratory, Centre Hospitalier Universitaire de Québec, and Laval University, Quebec City, Canada.

Address correspondence and reprint requests to Omar Moreira Bacha, MD, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Ciências Médicas, 165 Afonso Alvares St, Porto Alegre, Brazil 91920-430. E-mail: omarmbacha@terra.com.br.

Omar M. Bacha is a former Fellow in Gynecologic Oncology at Hotel Dieu de Québec, Laval University. At present, he works at Hospital de Clínicas de Porto Alegre, Brazil.

The authors declare that there are no potential conflicts of interest.

Received December 31, 2011

Accepted March 28, 2012

Copyright © 2012 by IGCS and ESGO