36 year old woman is found tested positive for BRCA 1 mutation. Her mother died due to ovarian cancer. She wishes to lower risk of ovarian cancer. Her general condition is otherwise normal. Which surgery would you recommend
Removing both fallopian tubes and ovaries is the best way to reduce the risk of ovarian cancer (90%) and premenopausal breast cancer (50%).
Bilateral oophorectomy
Subtotal hysterectomy and bilateral oophorectomy
Bilateral salpingo oophorectomy
Total hysterectomy and BSO.