ArticleScientific reports2026
Determinants of intention to undergo risk-reducing salpingo-oophorectomy among high-risk women for breast and ovarian cancer.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To evaluate the intention of women at high risk for breast and ovarian cancer to undergo risk-reducing salpingo-oophorectomy (RRSO) after genetic testing, and to identify the main factors related to their decision-making. A prospective cohort study conducted at the high-risk outpatient clinic of the State University of Campinas (UNICAMP), including 355 high-risk women followed between November/2021 and October/2022. Participants answered clinical and sociodemographic questionnaires, underwent comprehensive genetic testing, and received pre- and post-test genetic counseling. The majority were white (60.3%), younger than 50 years (71.5%) with a mean age of 43 years, and premenopausal (61.6%). 355 patients were tested and 102 (28,7%) carried likely pathogenic or pathogenic variants, 59,3% in the BRCA 1 and 2 genes. Before testing, 42.5% expressed the intention to undergo RRSO, which decreased to 33.4% after counseling (p < 0.05). The pre-test desire was more frequent in women aged 40-49 years, premenopausal, and with higher education (p < 0.05). In multiple regression, the desire for risk-reducing mastectomy (OR ≈ 39, 95% CI 16,8-90,79, p < 0,0001), the presence of pathogenic variants in BRCA (OR 15,46, 95% CI 6.05-39.53, p < 0,0001), and a personal history of cancer (OR 2,69, 95% CI 1.52-4.75, p < 0,0001) were independently associated with the intention to undergo RRSO. Intention to undergo risk-reducing salpingo-oophorectomy was higher among younger and premenopausal women and those with higher educational attainment and was strongly associated with the desire to undergo risk-reducing mastectomy and a personal history of breast or ovarian cancer. Changes in intention after genetic testing reflected gene-specific risk stratification: intention was withdrawn predominantly among women without high-penetrance BRCA variants, whereas it was adopted primarily among those carrying pathogenic variants in high-risk genes. These findings underscore the importance of access to germline genetic testing to support individualized, risk-informed decision-making regarding high-complexity preventive strategies.
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