Hello and welcome to September journal club! I’m Kathleen, PGY2 OBGYN resident at St. Luke’s in PA, and I’ll be your host for @AAGLJMIG journal club today. We’ll be discussing salpingectomy alone approach for risk reduction of ovarian cancer (see last tweet for link) #jmigjc
Throughout today and tomorrow, I’ll be posting about the article and responding to you in between cases and clinic. Hoping we can get some great discussion going! I’ll start with background this morning and return in the afternoon #jmigjc
As we all know, risk reducing salpingo-oophorectomy (RRSO) is recommended as the standard of case for patients with genetic dispositions to #OvarianCancer. The fallopian tube is now well established as site of origin for most ovarian cancers. #jmigjc
Removal of ovaries carries significant side effects: loss of #fertility and abrupt premature #menopause. This finding led to development of new surg techniques: salpingectomy with delayed oophorectomy (SDO). I’d love to hear from you! Have you tried this in your practice? ⤵️⤵️⤵️
Current guidelines recommend #BRCA1 carriers undergo RRSO from 35-40, and #BRCA2 undergo RRSO from 40-45; however, only 60-70% of these patients undergo RRSO d/t concerns about surgical menopause. #jmigjc
HRT is often rx to mitigate sx, but on the other side, doctors & providers are reluctant to offer HRT to an unaffected patient with a BRCA mutation, and many pts are not candidates if they have a personal hx of breast ca. Lethal risk vs. decreased QOL. Disappointing choices!
Salpingectomy with delayed oophorectomy (SDO) has entered the chat! After salpingectomy, extensive end process of fimbria is undertaken as well as washings to assess for occult HGSG. A survey showed 34% of eligible high risk women were "definitely interested" #jmigjc @FMIGS1
An SDO w/ #salpingectomy at age 36 followed by oophorectomy at 42 yielded favorable costs and life expectancy compared with RRSO at age 40! Going to stop here for awhile to hear your thoughts! #jmigjc @AAGL @AAGLFoundation #MIGS
@ThomasBoernerMD @KaraLongRoche (thanks for writing an awesome paper!) @drjakelauer @sadikah6 @DrStaciT @DrMTruong @cristobal_rdz @MigsRunner @malstumd @Dr_MicahWright @MIGS_TIPS @AllentownMigs @CourtneyFoxMD @docfoleygyn @VeronicaLerner @DrOlgaTheOBGYN
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