A Retrospective Study of 10 Cases of Laparoscopic and Laparotomic Risk-Reducing Salpingo-Oophorectomy Performed on Patients With BRCA-Positive Breast Cancer.

Background: Women who carry the breast cancer gene (BRCA)1/2 pathogenic variants have a higher lifetime risk of developing ovarian cancer than the general population (BRCA1, 44%; BRCA2, 17%). There is currently no reliable method for the early detection of ovarian cancer, and the prognosis of advanced ovarian cancer is poor. Therefore, risk-reducing salpingo-oophorectomy (RRSO) is recommended for patients with breast cancer who carry BRCA1/2 pathogenic variants. We retrospectively reviewed 10 cases of RRSO in such patients performed at our hospital.

Results: This study included 10 patients with BRCA-positive breast cancer who underwent RRSO after genetic counseling between April 2021 and December 2024. The patients ranged from 39 to 72 years of age (median, 43.5 years), and of the six premenopausal patients, three had symptoms of menopause requiring medication. The surgery types were as follows: laparoscopic surgery (n = 8), laparotomy (n = 1), and conversion from laparoscopy to laparotomy (n = 1). The operative times (median) were as follows: laparoscopy, 59-91 min (85 min), and laparotomy, 76-118 min (97 min). Postoperative histopathological testing revealed no cases of occult cancer or serous tubal intraepithelial carcinoma.

Conclusions: It is difficult to observe the upper abdomen in laparotomic RRSO, whereas laparoscopy allows for visualization of the entire abdominal cavity and a shorter operative time; therefore, laparoscopic surgery is considered a viable option. Post-RRSO patient management requires follow-up to monitor for the development of peritoneal cancer, and in premenopausal women in particular, treatment and follow-up for any symptoms of menopause are needed; therefore, individualized care is required.