ICARE Newsletter Winter 2013

Points to Consider Regarding Bilateral Salpingectomy as a Risk Reduction Procedure for Ovarian Cancer

Over the last few years, there has been evidence to suggest that a substantial proportion of ovarian cancer may start in the fallopian tubes, although some cancer clearly arises in the ovary.  As a result, removal of both fallopian tubes (called ‘bilateral salpingectomy’) has been suggested as an interim procedure to reduce risk in BRCA mutation carriers.1,2  But it is still very important to remember that there are no data available to tell us how effective this procedure is at reducing the future risk of ovarian cancer.

In essence, bilateral salpingectomy preserves ovarian function, thus it does not put premenopausal patients into premature menopause.   The procedure can be done through a minimally invasive approach, and may allow patients to defer removing their ovaries until they are closer to menopause.  In fact, a small study of 14 young BRCA mutation carriers documented the procedure as feasible.3 However, this study could not assess how effective the procedure was in reducing future ovarian cancer risk, nor was it able to assess whether the procedure had an effect on ovarian function.  Ultimately, until the usefulness of bilateral salpingectomy is more fully assessed, patients need to remember that this procedure does not eliminate their cancer risks as completely as if they had undergone a bilateral salpingo-oophorectomy (i.e. removal of both ovaries as well as the fallopian tubes).  As much as salpingectomy may become an important ovarian cancer risk reduction measure, it is exceedingly important to further study the validity of the procedure as a risk-reducing intervention in the context of research efforts.

1. Greene MH, et al. Am J Obstet Gynecol. 2011 Jan;204(1):19.e1-6. 2. Dietl J, et al. Hum Reprod. 2011 Nov;26(11):2918-24. 3. Leblanc E, et al. Gynecol Oncol. 2011 Jun 1;121(3):472-6.

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