Ovarian Cancer Previvors: How to manage these patients?
Ovarian cancer is lethal, screening programs do not significantly decrease mortality from this disease. However, Previvors can be identified. Previvors have a much greater predisposition to cancer than the general population but have not yet developed the disease.
Prophylactic salpingo-oophorectomy is currently recommended for women with deleterious BRCA1 mutation. Most women do not have this surgery at the recommended age. The side effect of premature menopause is cited as the main reason women delay. The alternative of salpingectomy with delayed ovarian resection has been proposed but remains controversial.
Pre-implantation genetic diagnosis via IVF after early surgery would prevent the transmission of deleterious genetic conditions to the next generation. This too is controversial.
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