Prophylactic
ovary removal also called prophylactic oophorectomy is a
surgical procedure to remove the ovaries and usually the
fallopian tubes. Women who are at high risk for breast and ovarian
cancer
sometimes choose prophylactic ovary removal to reduce
their risk. The ovaries are egg-producing organs in
addition to being the body's main source of the hormones
estrogen and progesterone. This benefit occurs only if
the ovary removal is done before menopause. Removing the
ovaries before menopause significantly reduces the level
of estrogen in a woman's body. As some breast cancers
require estrogen to grow, removing the ovaries may slow
or even stop the growth of breast cancer
cells. 
The
following criteria are taken into consideration for
evaluating the risk of breast as well as
ovarian cancer:
·
Mother,
sister, daughter with breast or ovarian cancer or both
especially before age 50.
·
Family
history of ovarian cancer in two or more
relatives.
·
Personal
history of early breast cancer before
menopause.
·
Personal
or family history of other cancers especially colorectal
or uterine cancer.
·
Male
family member with breast cancer.
·
Persons
of Ashkenazi Jewish ancestry. BRCA mutations are more
common
in women whose ancestors are of Eastern
European
Jewish
descent.
Prophylactic
ovary removal is recommended if there is evidence of
breast and/or ovarian cancer in the patient's family.
The presence of the BRCA1 or BRCA2
gene mutations can increase the risk of breast
and ovarian cancer. In BRCA1 carriers, ovary
removal had great benefits in terms of ovarian cancer
risk, but not breast cancer
risk.
Although
prophylactic
ovary removal can significantly reduce the risk of
developing ovarian cancer and also reduce the risk of
breast cancer when done before menopause, this surgery
is a serious choice that can have a considerable impact
on the patient's life. Prophylactic ovary
removal is permanent and irreversible. The sudden
loss of estrogen can cause a range of side effects, such
as hot flashes, depression, difficulty sleeping, and
lessened sex drive. Estrogen loss may affect bone and
heart health. Ovary removal also takes away the ability
to have children. Although prophylactic ovary removal
significantly reduces the risk of ovarian cancer, it
cannot completely eliminate the risk of developing an
ovarian-cancer-like illness called primary peritoneal
cancer. However,
there are alternatives that can be considered like
medications that shut down the ovaries temporarily e.g.
Zoladex, Lupron. Once these medications are stopped, the
ovaries start producing estrogen again. Medications such
as Tamoxifen and Arimidex can block or lower estrogen,
reducing the risk of breast cancer recurrence. Frequent
screening with clinical breast exams, mammograms, and
magnetic resonance imaging (MRI) every 6-12 months may
increase the chance of detecting breast cancer
early.
Prophylactic
ovary removal may have other long-term risks yet to be
discovered. Doctors do not fully understand how the loss
of estrogen could impact heart health, mental
functioning, memory, and other aspects of women's
health. Before considering prophylactic oophorectomy, a
visit to a holistic medicine practitioner is
recommended. He can further evaluate your risk taking
into account your health and lifestyle and guide you to
overcome the risks. Even after oophorectomy, changes in
lifestyle would help overcome the effects of surgical
menopause.
