The Role of Prophylactic Oophorectomy in the Management of Hereditary Breast & Ovarian Cancer Syndrome

Prophylactic salpingo-oophorectomy (PO) entails removal of the ovaries prior to the clinical occurrence of cancer. Prophylactic removal of the ovaries, during hysterectomy or other abdominal surgery, to prevent ovarian cancer in postmenopausal women was popularised in the 1940s by Crossen, who stated “the involuting ovaries have fulfilled their reproductive and endocrine function. They are....vestigial structures which carry a special tendency to cancer” (Crossen, 1942). The first report of prophylactic oophorectomy for familial ovarian cancer was in 1950 when A.M Liber described a family of five sisters and their mother, all with histologically confirmed papillary adenocarcinoma of the ovary; it was recommended that family members should undergo frequent gynaecologic screening, and that prophylactic oophorectomy should be considered (Liber, 1950)