A 35-year-old woman is found to have a BRCA2 pathogenic variant. She has completed her family. She elects prophylactic bilateral salpingo-oophorectomy (PBSO). Which of the following is the recommended timing for PBSO in BRCA2 mutation carriers according to current guidelines?
- A By age 35–40 years
- B By age 45–50 years after completion of childbearing ✓
- C By age 40–45 years
- D Immediately at diagnosis regardless of age
Correct answer: B. By age 45–50 years after completion of childbearing
Explanation
BRCA2 carriers have a lower and later peak of ovarian cancer risk compared to BRCA1 carriers; therefore, PBSO is recommended by age 40–45 for BRCA1 and by age 45–50 for BRCA2. Delaying PBSO to the late 40s in BRCA2 carriers balances ovarian cancer risk reduction against the adverse effects of surgical menopause (cardiovascular, bone, cognitive). PBSO reduces ovarian cancer risk by approximately 80–95% and also decreases breast cancer risk if performed premenopausally.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.