FIG 1.

Clinical guide for RRSO for OC by cancer susceptibility gene (decision aid for RRSO for OC in moderate-penetrance genes). This figure provides a clinical guide to assess benefit of RRSO for OC on the basis of the cancer susceptibility gene implicated. The y-axis represents estimated cumulative lifetime risk of OC, and the x-axis represents increasing risk for OC and evidence to support RRSO. Population risk for OC (1%-2%) and RRSO threshold (3%-4%) are plotted. Mutations in genes to the right of the dotted line represent clinical situations where there is likely benefit to RRSO for mutation status alone. Genes that overlap the RRSO threshold require careful consideration of risks and benefits of RRSO, considering family history, individual risk factors, risks of RRSO and premature menopause, and patient preference. Color coding indicates the age to consider RRSO on the basis of age at which increased risk starts to exceed population-level risk and areas of controversy and insufficient data. NOTE. It is reasonable to consider RRSO earlier than the recommended age in those with a significant family history of OC, typically 5-10 years before the earliest diagnosed OC. OC, ovarian cancer; RRSO, risk-reducing bilateral salpingo-oophorectomy.