Should risk-reducing surgery in women from hereditary breast ovarian cancer families be confined to removal of the fallopian tubes with ovarian conservation?

Cancers attributed to ovarian origin are relatively uncommon in the USA general population, accounting for only 2.6% of cancers in women [1]. Yet, this disease is responsible for 14.2% of the cancer deaths in American women [1]. Over 21,000 women are expected to be diagnosed in the USA with ovarian cancer during the next year [1].

When detected and treated in its earliest stage, those who may be diagnosed with ovarian cancer have relatively good prognosis for survival; however, the majority of ovarian cancers have not been diagnosed until quite advanced when the outlook for relapse-free survival has been gravely disappointing [1,2]. Thus far, available methods of screening for ovarian cancer, including serial serum CA-125 tests, transvaginal ultrasound scans and bimanual pelvic examinations have not been effective for reducing morbidities and mortality caused by ovarian cancer in general populations or in women at high hereditary risk for the disease [1,3–5].

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