science

Prophylactic salpingectomy

Prophylactic salpingectomy is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Prophylactic salpingectomy rather than just read about it. In short: Prophylactic salpingectomy is a preventative surgical technique performed on patients who are at higher risk of having ovarian cancer, such as individuals who may have pathogenic variants of the BRCA1 or BRCA2 gene. Originally salpingectomy was used in cases of ectopic pregnancies.

Key takeaways

Prophylactic salpingectomy belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Prophylactic salpingectomy to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Prophylactic salpingectomy from memory before moving on to harder problems.

Reference excerpt

Prophylactic salpingectomy is a preventative surgical technique performed on patients who are at higher risk of having ovarian cancer, such as individuals who may have pathogenic variants of the BRCA1 or BRCA2 gene. Originally salpingectomy was used in cases of ectopic pregnancies. As a preventative surgery, however, it involves the removal of the fallopian tubes. By not removing the ovaries this procedure is advantageous to individuals who are still of child bearing age. It also reduces risks such as cardiovascular disease and osteoporosis which are associated with the removal of the ovaries.

Indications In 2013 in America alone there were 22,000 cases of ovarian cancer diagnosed and reported. Of these 10% were due to an inherited disorder. It is also the fifth most common cancer related cause of death in women. The BRCA1 and BRCA2 genes are the most common inherited genetic mutations which lead to ovarian cancer. As such a preventative surgery such as prophylactic salpingectomy is thought to decrease this risk of getting cancer. Recent research has shown that ovarian cancer may not originate in the ovaries themselves but start in the fallopian tubes. It is therefore thought that in women who are of child bearing age the more common salpingo-oophorectomy may not be the correct surgery of choice.

A bilateral prophylactic salpingectomy with ovarian conservation was proposed as a "middle-ground" method of primary prevention, with the benefit of removing potential tissue of origin without the risks of surgical menopause. This method has been proposed for clinical trials in high-risk patients, but results are not currently available. Potential indications for Prophylactic Salpingectomy:

At the time of abdominal or pelvic surgery instead of tubal ligation or hysterectomy Women at a high-risk of developing serous ovarian cancer due to their inheritance of a germline mutation in a cancer predisposition gene, such as BRCA1 and BRCA2, once childbearing is complete. Interim procedure in women with BRCA1/2 mutations, enabling them to delay oophorectomy In 2013, the SGO released a clinical practice statement recommending that a bilateral salpingectomy should be considered "at the time of abdominal or pelvic surgery, hysterectomy, or in lieu of tubal ligation". The American College of Obstetricians and Gynecologists (ACOG) recommended that the procedure should be considered for population-risk patients: those without increased risk based on personal or family history, but they were clear that the approach to pelvic surgery, hysterectomy, or sterilization should not change simply to increase the chances of completing bilateral salpingectomy. The proposed plan of the British Columbia Ovarian Cancer Research Group program, involved performing opportunistic salpingectomy with benign hysterectomy or in lieu of bilateral tubal ligation for permanent contraception. It is suggested that this approach would yield a 20-40 percent population risk reduction for ovarian cancer over the next 20 years. However, overall there is insufficient evidence to support this practice as a safe alternative and risk-reducing bilateral salpingo-oophorectomy remains the recommended standard of care for high-risk women.

Clinical Trials and Evidence There are currently 2 ongoing clinical trials regarding prophylactic salpingectomy; 1) A study focusing on prophylactic salpingectomy with delayed oophorectomy (PSDO) in reducing risk of ovarian cancer. PSDO will result in the patient not immediately going through the menopause after the surgery, this will only happen once the ovaries are removed. Study is estimated to be complete in August 2018. 2) Another study looking at BRCA-positive women who are reluctant to undergo prophylactic surgery – this refusal increase risk of developing serious pelvic carcinoma. This study looks at the removal of the fimbriae structures of the ovaries. Results for this study are expected in October 2017. [Both of these studies have been completed. Who can add the results of these studies (and others) to this article?] BRCA1/2 mutation carriers are recommended salpingectomy at around the age of 40 to decrease their risk of ovarian cancer. Salpingectomy is most effective if performed before the natural menopause occurs, it was also found that there is no increased complication risks when salpingectomy is done at the same time as hysterectomy. A Nationwide study found statistically lower risk of ovarian cancer among women with previous salpingectomy when compared to the unexposed population. Bilateral salpingectomy is associated with a 50% decrease in ovarian cancer risk compared to unilateral salpingectomy (the removal of both or one fallopian tubes). Most protective effect was seen in women who had a bilateral salpingectomy. High-Grade Serous Carcinoma (HGSC) is usually driven by BRCA gene mutations – it was hypothesised that a decrease risk of ovarian cancer observed among women with salpingectomy reflects the effect of the removed tubal epithelium (fallopian tube). Those at risk are recommended sapling-oophorectomy at around the age of 40/after child-bearing to reduce ovarian cancer risk, and also reduces breast cancer too. Removal of healthy ovaries is also associated with negative health effects due to oestrogen deficiency, leaving the ovaries intact within the reproductive system is balanced with the remaining breast cancer risk. This was the first population based study describing the association between removing fallopian tubes and decreasing risk of ovarian cancer.

Risks of Procedure

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Illustrations

Worked examples

Example 1 — a first encounter with Prophylactic salpingectomy

Start with the simplest possible case. Write down what Prophylactic salpingectomy claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Prophylactic salpingectomy before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Prophylactic salpingectomy ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Prophylactic salpingectomy

In research: Prophylactic salpingectomy appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Prophylactic salpingectomy in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Prophylactic salpingectomy is common in secondary-school and first-year university syllabi. It links to neighbouring topics Surgical procedures and techniques, so understanding it makes those chapters shorter.
In everyday life: Look for Prophylactic salpingectomy outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Prophylactic salpingectomy in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Prophylactic salpingectomy means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Prophylactic salpingectomy out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Prophylactic salpingectomy in simple terms?

Why does Prophylactic salpingectomy matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Prophylactic salpingectomy?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Prophylactic salpingectomy.