Surgery - Oophorectomy
Oophorectomy is a surgical procedure where the ovaries are removed. It is also called ovarian ablation. The ovaries are two small glands that are part of the female reproductive system. They produce eggs and the female hormones estrogen and progesterone.1
Many breast cancers are hormone receptor-positive (HR+), meaning these cancers have receptors for hormones on the surface of their cells. When certain hormones attach to these receptors, it can fuel cancer’s growth.
Oophorectomy may be used in women who are premenopausal with hormone receptor-positive breast cancer, particularly those who cannot tolerate or refuse treatment with chemotherapy. By removing the ovaries, this significantly reduces the amount of estrogen and progesterone in the body and takes away that fuel for the breast cancer cells. Oophorectomy may also potentially be used to reduce the risk of developing breast cancer in women who are at high risk of the disease, such as those with a known genetic mutation (like BRCA1 or BRCA2).
BRCA1 or BRCA2 mutations also increase the risk of developing ovarian cancer, and removal of the ovaries can reduce this risk as well.2,3
How oophorectomy is performed
Oophorectomy may be performed as an open procedure or as a laparoscopic procedure. In an open procedure, one incision is made across the lower abdomen to remove both ovaries. A laparoscopic procedure is a minimally invasive procedure in which three or four small incisions are made into the abdomen. Instruments are placed through these incisions, including a lighted camera and surgical tools. The ovaries are removed through one of the small incisions.
In some cases, a laparoscopic oophorectomy is performed using robotic assistance. Minimally invasive procedures generally cause less pain and have faster recovery times. However, not everyone is a good candidate for this type of procedure.4
Side effects of oophorectomy
Removal of the ovaries immediately puts a woman’s body into menopause, which can cause hot flashes, vaginal dryness, mood swings, decreased sex drive, increased risk of heart disease, and increased risk of osteoporosis. The removal of the ovaries also means that the woman will not be able to become pregnant. As with any surgical procedure, an oophorectomy also has risks of bleeding, infection, and/or damage to nearby tissues or organs.4
Preparing for an oophorectomy
Oophorectomy is typically performed in a hospital under general anesthesia, a medication that puts you to sleep for the procedure. Prior to surgery, the patient may be asked by their doctor to not eat and to stop taking certain medications. Recovery is very individual, but some women may be kept in the hospital for a few days following the procedure.4
Because oophorectomy removes the possibility of being able to conceive a child naturally, women may want to discuss options for preserving their fertility with their doctor prior to the surgery.4
Oophorectomy may not be the right option for all premenopausal women with HR+ breast cancer. Other options can include2,3:
- Chemotherapy, which often causes menstruation to stop and may induce menopause
- Hormone therapy with luteinizing hormone-releasing hormone (LHRH) agonists, which blocks the hormone that is released by the pituitary gland to trigger the ovaries to produce estrogen
- Hormone therapy with an anti-estrogen like tamoxifen, which blocks estrogen receptors