At what age is it recommended to consider risk-reducing bilateral salpingo-oophorectomy (RRBSO) in women with BRCA1 mutations?

The recommendation for risk-reducing bilateral salpingo-oophorectomy (RRBSO) in women with BRCA1 mutations is typically advised between the ages of 35 to 40 years. This age range is based on the increased risk of ovarian and breast cancer associated with BRCA1 mutations and the understanding of how surgical intervention can significantly reduce that risk.

Women carrying BRCA1 mutations have an estimated lifetime risk of developing ovarian cancer that approaches 40-60% and breast cancer risk that can be as high as 80%. By considering RRBSO during this age window, women can reduce their risk of developing these cancers substantially. In particular, removing the ovaries can decrease the risk of ovarian cancer to nearly zero and also has an impact on breast cancer risk, especially when performed before the onset of menopause.

Timing is crucial, as performing the procedure too early can have implications for reproductive plans, while delaying it can increase cancer risk. The 35-40 age range is a balance that takes into account both the increasing cancer risks and the potential effects on hormone levels and fertility. Recommendations can vary slightly based on family history, personal preferences, and overall health, but the consensus supports this timing specifically for BRCA1 mutation carriers.