Bilateral Salpingooforectomy (BSO) and Breast Cancer Risk Reduction

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Although BRCA1 associated breast cancers tend to be triple negative and not influenced by estrogen:
    • A 37% reduction in breast cancer risk is seen after BSO
  • In BRCA2 mutation carriers:
    • BSO confers a 64% breast cancer risk reduction
  • Eisen et al:
    • Showed that BSO before the age of 50 led to a greater reduction in breast cancer risk compared to patients who underwent BSO after the age of 50
  • Given that chemotherapy-induced cessation of menses:
    • Reduces estrogen exposure:
      • The added reduction from BSO in patients with chemotherapy-induced menopause is not as significant as in patients with intact ovarian function
  • In a study by Domchek et al:
    • BSO reduced breast cancer specific mortality, ovarian cancer specific mortality and overall mortality by 90%, 95%, and 76%, respectively in BRCA mutation carriers
  • A prospective study by Kostopoulos:
    • Examined the effect of BSO on breast cancer risk and found the largest risk reduction provided by BSO among premenopausal BRCA2 mutation carriers
  • References
    • Domchek SM, Friebel TM, Singer CF, Evans DG, Lynch HT, Isaacs C, et al. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA. 2010;304(9):967-975.
    • Eisen A, Lubinski J, Klijn J, Moller P, Lynch HT, Offit K, et al. Breast cancer risk following bilateral oophorectomy in BRCA1 and BRCA2 mutation carriers: an international case-control study. J Clin Oncol. 2005;23(30):7491-7496.
    • Kotsopoulos J, Huzarski T, Gronwald J, Singer CF, Moller P, Lynch HT, et al. Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst. 2017;109(1).
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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