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RRSO BRCA Timing — SCE Medical Oncology MCQ

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EasyCancer GeneticsRRSO BRCA TimingSCE Medical Oncology

A 55-year-old woman with hereditary breast-ovarian cancer syndrome asks about risk-reducing salpingo-oophorectomy (RRSO). She is BRCA1 positive and has completed childbearing. When should RRSO be performed?

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Correct answer: B — RRSO is recommended by age 35-40 for BRCA1 carriers (or 40-45 for BRCA2) — it reduces ovarian/fallopian tube/peritoneal cancer risk by ~80% and breast cancer risk by ~50% if performed premenopausally; it is the single most effective risk-reducing intervention for BRCA carriers

RRSO for BRCA1: recommended age 35-40 (after childbearing); BRCA2: age 40-45. Benefits: ~80% reduction in ovarian/tubal/peritoneal cancer, ~50% reduction in breast cancer (if premenopausal). Risks: surgical menopause (HRT can be used until age 51 unless breast cancer history). Salpingectomy alone (removing tubes only) is being evaluated in clinical trials but is NOT yet standard.

Reference: NICE CG164; ESMO 2024 Hereditary Cancer; Kauff et al NEJM 2002