Prophylactic Ovary Removal
If you’re at high risk of developing breast cancer, ovarian cancer, or both, you might consider having your ovaries removed before menopause to reduce your cancer risk. Doctors call this surgery a prophylactic oophorectomy.
The ovaries — located on either side of the uterus — are the organs where eggs form. They’re also the main source of the hormones estrogen and progesterone before a woman goes through menopause.
Types of oophorectomy
There are a few different types of oophorectomy:
Unilateral oophorectomy: removes ovary on one side of the body
Bilateral oophorectomy: removes both ovaries
Salpingo-oophorectomy: removes the fallopian tube (the organ that transports eggs from the ovaries to the uterus) along with the ovary (or ovaries)
How does oophorectomy lower breast cancer risk?
Estrogen and progesterone fuel the growth of hormone receptor-positive breast cancers. Removing the ovaries before menopause greatly reduces the amount of these hormones in the body. This helps to reduce the risk of hormone receptor-positive breast cancer developing and growing.
While removing the ovaries after menopause reduces the risk of ovarian cancer, it doesn’t reduce the risk of breast cancer. This is because after menopause, the ovaries produce little or no estrogen and progesterone.
What to expect with ovary removal surgery
Before prophylactic oophorectomy, your doctor will typically do tests to make sure the ovaries are healthy. These may include:
transvaginal ultrasound, which creates images of the ovaries
CT scan or other imaging test
CA125 blood test, to check for a protein that can be elevated if ovarian cancer is present
Prophylactic ovary removal can be done laparoscopically (a procedure using a thin, lighted tube with a camera) or with a more traditional abdominal surgery, called laparotomy. Your doctor may recommend a laparotomy if there’s any reason to believe that cancer cells are in or near your ovaries.
What happens on the day of surgery depends on the type of procedure you’re having. If you have laparoscopic surgery, you’ll likely leave the hospital the same day. If you have laparotomy surgery, you may spend between two and four days in the hospital.
Laparoscopic oophorectomy is considered a less invasive approach and is used in most cases. The surgery is often done outpatient (meaning you won’t have to stay overnight in the hospital) and usually has a quicker recovery and less pain than laparotomy.
You’ll likely receive general anesthesia before laparoscopic oophorectomy, which means you’ll be unconscious during the procedure. Less often, a doctor may perform this surgery using local anesthetic, numbing only specific areas of the body. If you’ll be asleep for the surgery, you’ll receive general anesthesia through an IV in your hand or arm. If you’ll be awake for the surgery, you’ll receive local anesthesia, which means only the area to be operated on will be numb.
First, your doctor makes a small incision on your abdomen and then inserts a tube to inflate the abdomen with carbon dioxide gas. This gives your doctor more room to do the surgery. Next, your doctor makes several small incisions on your abdomen and then inserts a long, thin video camera and surgical tools into your body. Your doctor will use the tools to remove the ovaries — and fallopian tubes, if you’re having a salpingo-oophorectomy — through the small incisions. In some cases, your doctor may use a robot to control the camera and surgical tools.
If your doctor sees signs of ovarian cancer during the laparoscopic oophorectomy, they will likely switch you from laparoscopic oophorectomy to laparotomy oophorectomy.
A laparotomy oophorectomy is a more invasive procedure than a laparoscopic oophorectomy. You’ll receive general anesthesia through an IV in your hand or arm that will make you unconscious.
During the procedure, your doctor makes one long incision in your lower abdomen to remove your ovaries (and fallopian tubes, if you’re having a salpingo-oophorectomy). In most cases, the incision will be horizontal, just above your pubic bone.
Your doctor will send the tissue removed to a laboratory so it can be examined under a microscope to see if cancer is present.
No matter which procedure you have, after surgery, you’ll spend time in a recovery room until the anesthesia wears off.
Usually, you’ll be asked to start walking the day of surgery and you can eat your normal diet.
Before you leave the hospital, you’ll be shown how to clean and care for your incisions. You’ll likely be given a prescription for pain medicine. Your healthcare team will also talk to you about activities you should avoid during the first weeks of your recovery (for example, heavy lifting and exercise) and who to contact if you’re experiencing problems during your recovery.
As with any surgery, there are risks and side effects of ovary removal surgery to be aware of. It’s important to call your doctor right away if you notice signs of infection, such as fever, vomiting, or unusual redness or drainage from the incisions.
Questions to ask your surgeon
If you’re considering prophylactic ovary removal, you probably have a lot of questions. Here are some you may wish to ask your surgeon:
Do you recommend that I have my ovaries and fallopian tubes removed?
How should I prepare for surgery?
How long will surgery take?
Am I a good candidate for the less-invasive laparoscopic surgery?
How long will it take to recover?
Are there any precautions I should take as I recover? Will you give me written instructions to follow?
How will we work together to manage my follow-up care?
How often will I need to come in for follow-up appointments?
Will you manage all aspects of that care, or would you prefer that I see another doctor as well? If other doctors are involved with my care, how will you communicate with them?
In your experience with your patients, what are the common side effects of prophylactic ovary removal? How do you typically manage these side effects?
If I feel that I need to consult with additional medical specialists, will you be able to provide me with referrals?
What should I do if I have problems or questions in between visits? Who in your practice will be able to answer my questions?
If you’re not a candidate for oophorectomy or opt not to have it, there are alternatives to ovary removal surgery, including ovarian suppression medications.
— Last updated on August 7, 2025 at 2:50 PM
