The availability of genetic testing for inherited mutations in the BRCA1 and BRCA2 genes provides potentially valuable information to women at elevated risk of breast or
ovarian cancer. Unfortunately, women who have inherited a mutation in BRCA1 or BRCA2 have relatively few clinical management options available to reduce their risk of developing breast or
ovarian cancer. Because most options for
ovarian cancer prevention are not highly efficacious, many high-risk women consider the option of bilateral prophylactic
oophorectomy (BPO), in the hope that removal of healthy ovarian tissue will reduce their risk of developing invasive
malignancy. It is clear that BPO cannot completely prevent the subsequent development of
ovarian cancers because reports have been made of patients who have developed
cancers of epithelial ovarian origin subsequent to surgery. However, a number of studies have suggested that BPO may reduce the risk of subsequent breast or
ovarian cancers in women. In general, these studies have been conducted in women who represent a heterogeneous group with respect to breast/
ovarian cancer risk. Only one study of BPO has been undertaken in women whose elevated
cancer risk has been based on knowledge of inherited mutations. This study indicated that a 50% to 70%
breast cancer risk reduction could be achieved in women with BRCA1 mutations who underwent BPO. However, substantial additional information is required to provide clinically useful information about
cancer prevention to women who carry mutations in BRCA1 or BRCA2.