Prophylactic Oophorectomy andor Hysterectomy

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Several studies have documented lower breast cancer incidence among women who underwent oophorectomy at a young age. The effect of hysterectomy on breast cancer risk is less clear, but it has been postulated that hysterectomy may have some secondary effects by affecting ovarian blood flow and ovulation. Schairer and colleagues evaluated 15,844 women undergoing surgery in the Uppsala health care region of Sweden and found a 50 percent reduction in breast cancer risk in those women who underwent bilateral oophorectomy prior to age 50 years, compared with the risk of the background population.146 Hysterectomy alone had no consistent association with change in breast cancer risk. In a case-control series from Italy, women who underwent premenopausal oophorectomy with hysterectomy or hysterectomy alone had reduced relative risk of developing breast cancer (0.8 and 0.7, respectively).147 However, given the importance of the ovarian function in maintaining cardiovascular and bone health, there are presently no indications for recommending these procedures as prophylaxis against breast cancer in any subset of patients.

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