title: Acceptability of prophylactic salpingectomy with delayed oophorectomy as risk-reducing surgery among BRCA mutation carriers.
abstract: OBJECTIVE
  Given the emerging evidence for the fimbria as the site of origin for many serous carcinomas in BRCA mutation carriers, consideration is being given in studying prophylactic salpingectomy with delayed oophorectomy (PSDO) as a risk-reducing surgery. We aimed to determine the interest in a study of PSDO among these women.
  
  
  METHODS
  We evaluated the results of an online survey conducted by Facing Our Risk of Cancer Empowered (FORCE), a patient advocacy group, from October 2010 to August 2012. Premenopausal BRCA mutation carriers with no history of ovarian cancer or prior bilateral salpingo-oophorectomy (BSO) were included.
  
  
  RESULTS
  Of the 204 women meeting inclusion criteria, median age was 35 years, 92.5% were white, 25.7% were Jewish, and 16.7% had a history of breast cancer. Overall, 34.3% reported interest in a study of salpingectomy, 35.3% were unsure, and 30.4% were not interested in the study. Women noted the possibility of lowering ovarian cancer risk without menopause as a compelling reason to participate (83.8%). Reasons for not participating in a salpingectomy study included surgical complications (46.6%), potential ovarian damage (42.2%), planning BSO soon (32.4%), and surgical costs (32.8%). Acceptable study risks included the need for two surgeries (77.2%), possibility of not lowering ovarian cancer risk (68%), and disruption of ovarian blood supply (66.5%).
  
  
  CONCLUSIONS
  One-third of BRCA mutation carriers indicated definite interest in a PSDO study. Potential study risks were acceptable to most women. These findings suggest that patient accrual for a clinical trial of prophylactic salpingectomy with delayed oophorectomy is possible.
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: llholman@mdanderson.org.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Holman
authors.affiliation: Facing Our Risk of Cancer Empowered (FORCE), Tampa, FL, USA.
authors.forename: Sue
authors.initials: S
authors.lastname: Friedman
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Molly S
authors.initials: MS
authors.lastname: Daniels
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
mesh_terms: D000328:Adult; D001294:Attitude to Health; D018284:Cystadenocarcinoma, Serous / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006579:Heterozygote; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology; D010052:Ovariectomy / Q000379:methods* / Q000523:psychology; D010342:Patient Acceptance of Health Care; D017697:Premenopause; D058994:Salpingectomy / Q000379:methods* / Q000523:psychology; D013997:Time Factors; D055815:Young Adult
keywords: BRCA; Delayed oophorectomy; Prophylactic salpingectomy; Risk-reducing surgery