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Re: BSO without hysterectomyFrom: AllanHo@aol.comSat Feb 2 11:03:41 2008
In a message dated 2/2/2008 5:02:27 AM Eastern Standard Time, henrygregor@yahoo.com writes: Allan, seems to me I could agree two cases doesn't make a convincing definitive conclusion...but, given the rarity of the condition of Fallopian CA (How many listers have seen such cases? I have seen one in more years than I really want to 'fess up to, hehe), I'd lay the info out to the patients and call it part of their informed decision making process. Givne the surgical invasiveness and potential for complication those opting for prophylactic surgery are already assuming, if they have no strong feellings re uterine retention, I would honor their requests for a hysterectomy, assuming they have had benefit of risk benefit counseling. Hank I have no strong objections to women who really want to have their uteri removed. This is more of an academic argument. How many women would have to be subjected to the additional risk of hysterectomy in order to avoid one case of interstitial Fallopian tube cancer? And doing a hysterectomy does not reduce the risk of primary peritoneal cancer. If there is ANY other indications for a hysterectomy, I would not hesitate to suggest one along with the risk reducing BSO. Otherwise, I would try to use the ACOG recommendation to reassure the patient that a hysterectomy would not be necessary. Allan
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