Oophorectomy if no personal history of breast cancer

Risk-reducing oophorectomy for women with no personal history of breast cancer

• risk-reducing bilateral oophorectomy is appropriate only for a small proportion of women who are from high-risk families and should be managed by a multidisciplinary team
• women considering risk-reducing bilateral oophorectomy should be informed of possible psychosocial and sexual consequences of the procedure and have the opportunity to discuss these issues
• women not at high risk who raise the possibility of risk-reducing bilateral oophorectomy should be offered appropriate information, and if seriously considering this option should be offered referral to the team that deals with women at high risk
• women undergoing bilateral risk-reducing oophorectomy should have their fallopian tubes removed as well

Breast cancer risk category

*This group includes known BRCA1, BRCA2 and TP53 mutations and rare conditions that carry an increased risk of breast cancer such as Peutz-Jegher syndrome (STK11), Cowden (PTEN) and familial diffuse gastric cancer (E-Cadherin)

Notes:

• HRT for women with no personal history of breast cancer who have a bilateral salpingo-oophorectomy before the natural menopause
  • when women with no personal history of breast cancer have either a BRCA1 or BRCA2 mutation or a family history of breast cancer and they have had a bilateral salpingo-oophorectomy before their natural menopause, offer them:
    • combined HRT if they have a uterus
    • oestrogen-only HRT if they don't have a uterus
    • up until the time they would have expected natural menopause (average age for natural menopause is 51-52 years)
  • manage menopausal symptoms occurring when HRT is stopped in the same way as symptoms of natural menopause
    
    

Reference:

• NICE (June 2013). Familial breast cancer - Classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer