Hereditary ovarian cancer

Based on the ESMO clinical practice guidelines for cancer prevention and screening in BRCA mutation carriers and other hereditary cancer syndromes, published on September 2016: the use of the oral contraceptive pill has been demonstrated to have a significant risk-reducing effect on the development of ovarian cancer by 40–60%; however, there are conflicts concerning breast cancer risk in these patients. There are no data proving that screening for ovarian cancer is able to reduce mortality, and several trials are still on going. Nowadays, the most effective measure for preventing ovarian cancer is the risk-reducing salpingo-oophorectomy (RRSO), which has consistently been shown to reduce the risk by 80–90%, reducing mortality as well. Based on ESMO guidelines, the RRSO should be carried out at age 35–40. In patients with RAD51 or BRIP1 mutations, RRSO may be considered, but after 45 years of age. Finally, based on several pieces of evidence suggesting that ovarian cancer originates in the fimbria or fallopian tubes, there is a growing interest in risk-reducing salpingectomy. However, this procedure alone cannot yet be recommended, outside the setting of a clinical trial [1].