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
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
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.
of Ashkenazi Jewish ancestry. BRCA mutations are more
common in women whose ancestors are of Eastern European
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.