Fallopian Tubes: Keep or Remove?
Ovarian cancer is a devastating disease. The pathogenesis of ovarian carcinomashas always remained unclear. Enough evidence is now available clearly highlighting distal fallopian tube as the site of origin for serous ovarian carcinomas particularly in women with BRCA mutations. The ovaries and fallopian tubes may not be simultaneously involved. After the completion of childbearing, there exists no known physiological benefit of retaining the fallopian tubes. Post-salpingectomy,the ovarian endocrine function remains unaffected. Removal of premenopausal ovaries leads to attainment of early surgical menopause. Prophylactic salpingectomy at hysterectomy for benign reasons or sterilization rules out any subsequent tubal pathology and offers considerable protection against later tumor development. Risk reducing salpingectomy even if the ovaries are retainedare beneficial especially in young women with BRCA mutations.