Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Atlantic Health System, Morristown, New Jersey; Obafemi Awolowo University, Ile-Ife, Nigeria; and the Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York.
Obstet Gynecol. 2020 Jun;135(6):1270-1274. doi: 10.1097/AOG.0000000000003864.
Women with germline BRCA1 or BRCA2 mutations have a lifetime risk of ovarian cancer of up to 46%. Opportunistic salpingectomy has been advocated as a risk-reducing strategy owing to increasing recognition of tubal origin, yet evidence of efficacy in this high-risk population is limited.
This is the case of a woman with a BRCA1 mutation who underwent prophylactic mastectomy and bilateral salpingectomy with ovarian retention before the age of 40 years. She did not undergo oophorectomy and subsequently developed stage IV high-grade serous ovarian cancer 4 years after her initial surgery.
More research is needed to determine the role of prophylactic salpingectomy with delayed oophorectomy, optimal timing of completion oophorectomy, and the risks and benefits compared with up-front risk-reducing salpingo-oophorectomy.
携带胚系 BRCA1 或 BRCA2 突变的女性终生患卵巢癌的风险高达 46%。由于越来越多的人认识到输卵管起源，因此主张进行机会性输卵管切除术作为一种降低风险的策略，但在这种高危人群中，其疗效的证据有限。
这是一位 BRCA1 基因突变携带者的病例，她在 40 岁之前接受了预防性乳房切除术和双侧输卵管切除术保留卵巢。她没有进行卵巢切除术，随后在最初手术 4 年后发展为 IV 期高级别浆液性卵巢癌。
需要更多的研究来确定预防性输卵管切除术加延迟卵巢切除术的作用、完成卵巢切除术的最佳时机，以及与预防性输卵管卵巢切除术相比的风险和益处。
