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Prophylactic Oophorectomy

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123. Fertility problems: assessment and treatment

2013] 1.3.10.5 Inform couples that sperm washing reduces, but does not eliminate, the risk of HIV transmission. [new 2013] [new 2013] 1.3.10.6 If couples who meet all the criteria in recommendation 1.3.10.2 still perceive an unacceptable risk of HIV transmission after discussion with their HIV specialist, consider sperm washing. [new 2013] [new 2013] 1.3.10.7 Inform couples that there is insufficient evidence to recommend that HIV negative women use pre-exposure prophylaxis, when all the criteria (...) #notice-of-rights). Page 16 of 511.3.13.3 Prophylactic antibiotics should be considered before uterine instrumentation if screening has not been carried out. [2004] [2004] 1.4 Medical and surgical management of male factor fertility problems 1.4.1 1.4.1 Medical management (male factor infertility) Medical management (male factor infertility) 1.4.1.1 Men with hypogonadotrophic hypogonadism should be offered gonadotrophin drugs because these are effective in improving fertility. [2004] [2004] 1.4.1.2

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

124. Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer

For referral decisions, attempts should be made to gather as accurate information as possible on: age of diagnosis of any cancer in relatives site of tumours multiple cancers (including bilateral disease) Jewish ancestry [1] . [2004] [2004] F Family history-taking in secondary car amily history-taking in secondary care e 1.1.10 A family history should be taken when a person with no personal history of breast cancer presents with breast symptoms or has concerns about relatives with breast cancer. [2004 (...) history: bilateral breast cancer male breast cancer ovarian cancer Jewish ancestry sarcoma in a relative younger than age 45 years glioma or childhood adrenal cortical carcinomas complicated patterns of multiple cancers at a young age paternal history of breast cancer (two or more relatives on the father's side of the family). [2004] [2004] 1.3.2 People who do not meet the criteria for referral should be cared for in primary care by giving standard written information. [2004] [2004] Referr Referral

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

125. Prophylactic oophorectomy: Preventing cancer by surgically removing your ovaries

with a high risk of ovarian cancer and breast cancer might consider to reduce their risk. Preventive (prophylactic) bilateral oophorectomy carries benefits and risks that must be carefully balanced when considering this procedure. What is oophorectomy? Multimedia In an oophorectomy, a surgeon removes both your ovaries — the almond-shaped organs on each side of your uterus. Your ovaries contain eggs and secrete the hormones that control your reproductive cycle. If you haven't experienced menopause (...) oophorectomy isn't right for me right now, can I change my mind later? What advice would you give your friend or family member if she were in my situation? Determining whether prophylactic oophorectomy is right for you — and when it might be right for you — depends on your individual risk of cancer and how aggressive you want to be in your cancer prevention efforts. Feb. 08, 2018 Muto MG. Risk-reducing bilateral salpingo-oophorectomy in women at high risk of epithelial ovarian and fallopian tubal cancer

2009 Mayo Decision Aids

126. Prevention and Screening in BRCA Mutation Carriers and Other Breast/Ovarian Hereditary Cancer Syndromes

, Eisen A et al. Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers. J Natl Cancer Inst 1999; 91: 1475–1479. 35. Rebbeck TR, Kauff ND, Domchek SM. Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers. J Natl Cancer Inst 2009; 101: 80–87. 36. Heemskerk-Gerritsen BA, Seynaeve C, van Asperen CJ et al. Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers (...) et al. BRCA mutation carriers show normal ovarian response in in vitro fertilization cycles. Fert Steril 2015; 104: 1162–1167. 44. Peccatori FA, Azim HA, Jr, Orecchia R et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 (Suppl. 6): vi160–vi170. 45. Rebbeck TR, Friebel T, Wagner T et al. Effect of short-term hormone replacement therapy on breast cancer risk reduction after bilateral prophylactic oophorectomy in BRCA1

2017 European Society for Medical Oncology

127. Ovarian Hyperstimulation Syndrome, Management

enlargement and ascites should be kept in mind when considering a diagnosis of ectopic pregnancy. In rare cases of critical OHSS, termination of pregnancy has been reported in the situation of progressive thrombosis despite anticoagulation, 55 and there have been cases reported for removal of the ovaries (bilateral oophorectomy) for intractable OHSS; 56 however, this is not a recommended treatment option. 57 © Royal College of Obstetricians and Gynaecologists 17 of 22 RCOG Green-top Guideline No. 5 (...) reduced renal perfusion. RCOG Green-top Guideline No. 5 4 of 22 © Royal College of Obstetricians and Gynaecologists D P D D D D D D P DParacentesis should be carried out under ultrasound guidance and can be performed abdominally or vaginally. Intravenous colloid therapy should be considered for women who have large volumes of fluid removed by paracentesis. How should the risk of thrombosis be managed? Women with severe or critical OHSS and those admitted with OHSS should receive LMWH prophylaxis

2016 Royal College of Obstetricians and Gynaecologists

128. Endometrial Hyperplasia, Management of

and Gynaecologists 3 of 30 RCOG/BSGE Green-top Guideline No. 67 A A B A B C D D C C P PPostmenopausal women requiring surgical management for endometrial hyperplasia without atypia should be offered a bilateral salpingo-oophorectomy together with the total hysterectomy. For premenopausal women, the decision to remove the ovaries should be individualised; however, bilateral salpingectomy should be considered as this may reduce the risk of a future ovarian malignancy. A laparoscopic approach to total hysterectomy (...) -oophorectomy together with the total hysterectomy. For premenopausal women, the decision to remove the ovaries should be individualised; however, bilateral salpingectomy should be considered as this may reduce the risk of a future ovarian malignancy. Endometrial ablation is not recommended because complete and persistent endometrial destruction cannot be ensured and intrauterine adhesion formation may preclude endometrial histological surveillance. How should women with atypical hyperplasia who wish

2016 Royal College of Obstetricians and Gynaecologists

129. Guideline on the management of premature ovarian insufficiency

to Turner Syndrome should be offered HRT throughout the normal reproductive lifespan. C BRCA gene mutation or after breast cancer HRT is generally contra-indicated in breast cancer survivors. B HRT is a treatment option for women carrying BRCA1/2 mutations but without personal history of breast cancer after prophylactic bilateral salpingo- oophorectomy (BSO). C Endometriosis For women with endometriosis who required oophorectomy, combined estrogen/progestogen therapy can be effective for the treatment (...) for treatment of vaginal discomfort and dyspareunia for women not using HRT. C NEUROLOGICAL HEALTH What are the consequences of POI on neurological function? The possible detrimental effect on cognition should be discussed when planning hysterectomy and/or oophorectomy under the age of 50 years, especially for prophylactic reasons. D What are the management options for the effect of POI on neurological function? Estrogen replacement to reduce the possible risk of cognitive impairment should be considered

2015 European Society of Human Reproduction and Embryology

130. Management of Women with a Genetic Predisposition to Gynaecological Cancers

, the investigators suggested referral for genetic counselling and testing at initial diagnosis. 13 A Wellcome Trust-funded initiative is currently underway to investigate the feasibility and cost effectiveness of this approach within the National Health Service. 14 2.3 Risk-reducing surgery The mainstay of management for women who carry a constitutional BRCA1 or BRCA2 mutation is risk- reducing bilateral salpingo-oophorectomy (RRBSO) and risk-reducing breast surgery or breast screening. RRBSO in these women can (...) of these findings, it has been proposed that the tubal hypothesis of epithelial ovarian cancer pathogenesis offers an alternative surgical approach in younger women, comprising of risk-reducing bilateral salpingectomy while conserving their ovaries nearer to the age of natural menopause, when a delayed bilateral oophorectomy can be performed. 31 However, this surgical option is currently of unproven benefit as the long-term effect on ovarian cancer incidence and mortality in this patient group remains unknown

2015 Royal College of Obstetricians and Gynaecologists

131. Breast Cancer Treatment (PDQ®): Health Professional Version

383 (9922): 1041-8, 2014. [ ] Hartmann LC, Schaid DJ, Woods JE, et al.: Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med 340 (2): 77-84, 1999. [ ] Rebbeck TR, Levin AM, Eisen A, et al.: Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers. J Natl Cancer Inst 91 (17): 1475-9, 1999. [ ] Kauff ND, Satagopan JM, Robson ME, et al.: Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N (...) Engl J Med 346 (21): 1609-15, 2002. [ ] Rebbeck TR, Lynch HT, Neuhausen SL, et al.: Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 346 (21): 1616-22, 2002. [ ] Kauff ND, Domchek SM, Friebel TM, et al.: Risk-reducing salpingo-oophorectomy for the prevention of BRCA1- and BRCA2-associated breast and gynecologic cancer: a multicenter, prospective study. J Clin Oncol 26 (8): 1331-7, 2008. [ ] [ ] Rosen PP, Groshen S, Kinne DW, et al.: Factors influencing prognosis

2018 PDQ - NCI's Comprehensive Cancer Database

133. Unusual Cancers of Childhood Treatment (PDQ®): Health Professional Version

and obstruction. Headache. Otalgia. Otitis media. Given the rich lymphatic drainage of the nasopharynx, bilateral cervical lymphadenopathy is often the first sign of disease. The tumor spreads locally to adjacent areas of the oropharynx and may invade the skull base, resulting in cranial nerve palsy or difficulty with movements of the jaw (trismus). Distant metastatic sites may include the bones, lungs, and liver. Diagnostic and Staging Evaluation Diagnostic tests will determine the extent of the primary (...) are excellent, with 10-year survival rates exceeding 95%.[ , , ] Papillary thyroid carcinoma: Papillary thyroid carcinoma accounts for 90% or more of all cases of differentiated thyroid carcinoma occurring during childhood and adolescence. Pediatric papillary thyroid carcinoma may present with a variety of histological variants: classic, solid, follicular, and diffuse sclerosing. Papillary thyroid carcinoma is frequently multifocal and bilateral, and metastasizes to regional lymph nodes in most children

2018 PDQ - NCI's Comprehensive Cancer Database

134. Breast Cancer Prevention (PDQ®): Health Professional Version

, bilateral prophylactic mastectomy reduces the risk of breast cancer in women with a strong family history, and most women experience relief from anxiety about breast cancer risk. There are no studies examining breast cancer outcomes in women who undergo contralateral prophylactic mastectomy after surgery for ipsilateral breast cancer. Magnitude of Effect : Breast cancer risk after bilateral prophylactic mastectomy in women at high risk is reduced as much as 90%, but published study designs may have (...) produced an overestimate. Study Design : Evidence obtained from case-control and cohort studies. Internal Validity : Good. Consistency : Good. External Validity : Good. Prophylactic oophorectomy or ovarian ablation: benefits Based on solid evidence, premenopausal women with BRCA gene mutations who undergo prophylactic oophorectomy have lower breast cancer incidence. Similarly, oophorectomy or ovarian ablation is associated with decreased breast cancer incidence in normal premenopausal women

2018 PDQ - NCI's Comprehensive Cancer Database

135. Genetics of Breast and Gynecologic Cancers (PDQ®): Health Professional Version

tested for BRCA1/BRCA2 pathogenic variants.[ ] Short-term use of hormones for treatment of menopausal symptoms appears to confer little or no breast cancer risk.[ , ] The effect of HRT on breast cancer risk among carriers of BRCA1 or BRCA2 pathogenic variants has been studied in the context of bilateral risk-reducing oophorectomy, in which short-term replacement does not appear to reduce the protective effect of oophorectomy on breast cancer risk.[ ] (Refer to the section of this summary for more (...) relatives, age at diagnosis, the occurrence of bilateral or multiple ipsilateral breast cancers in a family member, and the number of affected male relatives.[ , , - ] A large population-based study from the Swedish Family Cancer Database confirmed the finding of a significantly increased risk of breast cancer in women who had a mother or a sister with breast cancer. The hazard ratio (HR) for women with a single breast cancer in the family was 1.8 (95% CI, 1.8–1.9) and was 2.7 (95% CI, 2.6–2.9

2018 PDQ - NCI's Comprehensive Cancer Database

136. Cancer Genetics Risk Assessment and Counseling (PDQ®): Health Professional Version

information:[ ] Primary site of each cancer. Obtaining medical documentation of key cancers (e.g., pathology reports, clinical documents, and death certificates) is especially relevant to risk assessment and/or management recommendations. (Refer to the section of this summary for more information.) Age at diagnosis for each primary cancer. Where the relative was diagnosed and/or treated. History of surgery or treatments that may have reduced the risk of cancer. For example, bilateral salpingo-oophorectomy (...) that suggest hereditary cancer:[ - ] Unusually early age of cancer onset (e.g., premenopausal breast cancer). Multiple primary cancers in a single individual (e.g., colorectal and endometrial cancer). Bilateral cancer in paired organs or multifocal disease (e.g., bilateral breast cancer or multifocal renal cancer). Clustering of the same type of cancer in close relatives (e.g., mother, daughter, and sisters with breast cancer). Cancers occurring in multiple generations of a family (i.e., autosomal dominant

2018 PDQ - NCI's Comprehensive Cancer Database

137. Genetics of Colorectal Cancer (PDQ®): Health Professional Version

on the other cancers associated with the syndrome. For example, regular has been shown to improve survival. Prophylactic surgery (colectomy) has also been shown to improve survival in . The timing and extent of risk-reducing surgery usually depends on the number of polyps, their size, histology, and symptomatology. For and a diagnosis of CRC, extended resection is associated with fewer metachronous CRCs and additional surgical procedures for colorectal neoplasia than in patients who undergo segmental

2018 PDQ - NCI's Comprehensive Cancer Database

138. Breast Cancer Prevention (PDQ®): Health Professional Version

, bilateral prophylactic mastectomy reduces the risk of breast cancer in women with a strong family history, and most women experience relief from anxiety about breast cancer risk. There are no studies examining breast cancer outcomes in women who undergo contralateral prophylactic mastectomy after surgery for ipsilateral breast cancer. Magnitude of Effect : Breast cancer risk after bilateral prophylactic mastectomy in women at high risk is reduced as much as 90%, but published study designs may have (...) produced an overestimate. Study Design : Evidence obtained from case-control and cohort studies. Internal Validity : Good. Consistency : Good. External Validity : Good. Prophylactic oophorectomy or ovarian ablation: benefits Based on solid evidence, premenopausal women with BRCA gene mutations who undergo prophylactic oophorectomy have lower breast cancer incidence. Similarly, oophorectomy or ovarian ablation is associated with decreased breast cancer incidence in normal premenopausal women

2018 PDQ - NCI's Comprehensive Cancer Database

139. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention (PDQ®): Health Professional Version

is generally reserved for women at high risk of developing ovarian cancer, such as women who have an inherited susceptibility to ovarian cancer. Magnitude of Effect : 90% reduction in risk of ovarian cancer observed among women with a BRCA1 or BRCA2 mutation. Study Design : Multiple case-control studies. Internal Validity : Good. Consistency : Good. External Validity : Good. Risk-reducing bilateral salpingo-oophorectomy: harms Based on solid evidence, prophylactic oophorectomy among women who are still (...) of ovarian cancer. Magnitude of Effect : 2% decrease with every month of breastfeeding.[ ] Study Design : Multiple case-control and cohort studies; meta-analysis. Internal Validity : Good. Consistency : Good. External Validity : Good. Risk-reducing bilateral salpingo-oophorectomy: benefits Based on solid evidence, risk-reducing bilateral salpingo-oophorectomy is associated with a decreased risk of ovarian cancer. Peritoneal carcinomatosis has been reported rarely following surgery. Risk-reducing surgery

2018 PDQ - NCI's Comprehensive Cancer Database

140. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®): Health Professional Version

to earlier detection. For women at increased risk, prophylactic oophorectomy may be considered after age 35 years if childbearing is complete. In a family-based study among 551 women with BRCA1 or BRCA2 mutations, of the 259 women who had undergone bilateral prophylactic oophorectomy, 2 (0.8%) developed subsequent papillary serous peritoneal carcinoma, and 6 (2.8%) had stage I ovarian cancer at the time of surgery. Of the 292 matched controls, 20% who did not have prophylactic surgery developed ovarian (...) cancer. Prophylactic surgery was associated with a reduction in the risk of ovarian cancer that exceeded 90% (relative risk, 0.04; 95% confidence interval, 0.01–0.16), with an average follow-up of 9 years;[ ] however, family-based studies may be associated with biases resulting from case selection and other factors that influence the estimate of benefit.[ ] After a prophylactic oophorectomy, a small percentage of women may develop a primary peritoneal carcinoma that is similar in appearance

2018 PDQ - NCI's Comprehensive Cancer Database

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