A new study using data from the NHS England National Disease Registration Service has uncovered important insights into outcomes associated with bilateral salpingo-oophorectomy (BSO – the surgical removal of both ovaries and fallopian tubes) in women who have previously been diagnosed with breast cancer. HDI employees Tameera Rahman (Health Data Scientist) and Craig Knott (Principal Analyst) were co-authors on the paper “Long-term outcomes of bilateral salpingo-oophorectomy in women with personal history of breast cancer” published in BMJ Oncology in February 2025.
BSO is often used to reduce the risk of ovarian cancer in high-risk women, including those with a personal history of breast cancer. It’s also used as a form of ovarian function suppression in certain hormone-sensitive breast cancers. But while BSO can dramatically lower the risk of ovarian cancer, findings from this study show that the surgery may also lead to increased risks of adverse long-term health outcomes.
Data was analysed from nearly 570,000 women diagnosed with invasive breast cancer in England between 1995 and 2019. Of these, over 23,000 had a BSO after their diagnosis. The study linked cancer registry data with hospital admissions records to explore long-term health impacts.
The findings revealed a 10% increase in the risk of cardiovascular disease in women who had a BSO before age 55. Those who underwent the procedure at age 55 or older still faced a 7% increased risk. The strongest link was with ischaemic heart disease, especially angina.
Regardless of age, BSO was associated with a 20% increased risk of depression. In women aged 55 or older, BSO was linked to a 21% increased risk of developing a second non-breast cancer. While BSO after age 55 was linked to a reduced risk of all-cause mortality (8% lower), this benefit was not seen in younger women.
These findings suggest that while BSO may provide cancer-prevention benefits, it also carries potential risks. More work is required to investigate the possibility of confounding by family history and genetic susceptibility.
The study reinforces the need for personalised counselling and shared decision-making when considering surgery.