Impact of incidental bilateral salpingo-oophorectomy in a family member on breast cancer risk assessment: clinical considerations.
BACKGROUND
Hysterectomy (TAH/TVH) with bilateral salpingo-oophorectomy (BSO) remains prevalent in the general population; however, current risk tools do not account for the potential impact of BSO on breast cancer risk calculations in family members.


METHODS
CancerGene software was used to estimate the effect of BSO in a family member on proband risk across a range of simulated family cancer histories.


RESULTS
Impact of BSO on proband risk appears most salient when it occurs in a first-degree relative. Race appears to modify the attainment of clinically significant risk thresholds, suggesting possible systematic risk underestimations among black women.


CONCLUSIONS
When clinicians calculate risk in families where a close relative had BSO, they may choose to supplement standard risk calculations with numerical ranges of risk that account for the risk-reducing effect of BSO. More consideration is needed of whether failing to account for BSO in risk models perpetuates race-based health disparities.
Salant
Talya
T
Pritzker School of Medicine, University of Chicago, Chicago, IL, USA. tsalant@uchicago.edu <tsalant@uchicago.edu>
Lauderdale
Diane S
DS
D000328:Adult; D001943:Breast Neoplasms / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D010052:Ovariectomy; D010375:Pedigree; D018570:Risk Assessment; D012307:Risk Factors; D012984:Software