At 52, when I was diagnosed with ER-positive breast cancer, I was not fully in menopause. After completing my treatment, my gynecologist suggested something I had never seriously considered before: an oophorectomy — the removal of my ovaries to lower estrogen levels and reduce my recurrence risk.
“When I learned that removing my ovaries could reduce my recurrence risk by around 50%, it was a powerful moment. My gynecologist did the surgery. It was outpatient, and while it wasn’t nothing, I felt a deep peace afterward knowing I had taken that step.”
— Cynthia, Stage 2B
Dr. Staci Tanouye, OB-GYN and Learn Look Locate Medical Advisor, shares that for individuals with BRCA1/2 mutations who haven’t yet had breast cancer, risk-reducing salpingo-oophorectomy (removal of the ovaries and fallopian tubes) has been shown to lower breast cancer risk, with some studies reporting reductions of up to 68%. However, when data are averaged across mutation types and timing of surgery, the reduction in risk is more consistently reported around the 40–50% range.
To provide further context, Dr. Tanouye explains that a risk-reducing bilateral mastectomy lowers breast cancer risk by approximately 90–95%. This comparison highlights that different preventive strategies come with varying levels of risk reduction, and decisions about which approach to take should be discussed thoroughly and individually.
For individuals who are not BRCA carriers but have already had ER-positive breast cancer, the surgical removal of the ovaries offers risk reduction similar to medical ovarian suppression (such as GnRH agonists like Lupron). However, one key distinction is that surgical menopause is permanent, unlike medical suppression, which can be reversed.
While removing the ovaries can reduce cancer risk, there are trade-offs to consider:
However, there is promising news: new non-hormonal medications for managing these symptoms are giving women more options than ever before.
Dr. Tanouye also mentioned emerging research from the Menopause Society meeting, particularly around BRCA previvors (those who have not had cancer yet). Research suggests that removing the ovaries, tubes, and possibly the uterus may allow for estrogen-only hormone therapy, which might not increase breast cancer risk and could even be protective in certain contexts.
The most important message is that there is no one-size-fits-all solution when it comes to breast cancer risk reduction. The decision to undergo an oophorectomy or choose another risk-reducing strategy must be individualized, carefully weighed, and fully supported over time. Each patient’s situation is unique, and their preferences and medical needs must guide their choices.
At Learn Look Locate, we’re committed to empowering individuals with information and support to make the best decisions for their health. Oophorectomy and surgical menopause may be part of the conversation, but the ultimate decision should always reflect a thorough understanding of the risks, benefits, and alternatives available. If you’re considering these options, it’s important to have ongoing conversations with your gynecologist and oncology team to ensure that your treatment plan is tailored specifically to your needs.
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