Risk-Reducing Gynecologic and Breast Surgery: Outcomes, Access, and Innovation in Hereditary Cancer Syndromes

Hereditary cancer syndromes—principally hereditary breast and ovarian cancer (HBOC) syndrome and Lynch syndrome—confer dramatically elevated lifetime risks of gynecologic malignancies, including ovarian, fallopian tube, and endometrial cancers. To reduce morbidity and mortality, risk-reducing gynecologic surgery remains the primary clinical intervention for these high-risk individuals. Prophylactic procedures such as risk-reducing salpingo-oophorectomy (RRSO) and risk-reducing salpingectomy with delayed oophorectomy (RRSDO) are at the forefront of clinical discussion. In parallel, risk-reducing hysterectomy plays a vital role in managing endometrial cancer risk. While the focus of this collection remains centered on gynecologic surgery, concurrent risk-reducing breast surgery (such as prophylactic mastectomy) is also welcomed as an adjacent consideration in the holistic management of hereditary cancer syndrome carriers.Despite the opportunity for surgical risk reduction, questions persist around timing, technique, oncologic adequacy, menopausal sequelae, and access to care. Uptake of risk-reducing surgery remains suboptimal. Cascade genetic testing rates remain low, and barriers to genetic services and surgical referral among minoritized and underserved populations continue to drive inequitable outcomes. At the same time, rapid advances in digital health, AI-assisted risk stratification, and patient decision-support tools are reshaping how high-risk individuals are identified, counseled, and guided toward surgery – opening new possibilities for equitable, personalized care.This Research Topic invites original research, systematic reviews, meta-analyses, case reports, and perspectives that advance understanding of risk-reducing gynecologic surgery across the full clinical and translational spectrum. We particularly welcome work that bridges surgical science with health equity, patient-centered outcomes, and innovation in hereditary cancer care.Topics of Interest Include:• Surgical outcomes and complications of risk-reducing salpingo-oophorectomy, risk-reducing salpingectomy, and risk-reducing salpingectomy with delayed oophorectomy in hereditary cancer syndrome carriers• Optimal timing and clinical sequencing of risk-reducing gynecologic surgery across the lifespan• Oncologic, reproductive, and quality-of-life outcomes following risk-reducing procedures• Menopausal consequences of oophorectomy and strategies for hormonal management in high-risk patients• Pathologic evaluation of risk-reducing surgical specimens, including SEE-FIM protocols and detection of precursor lesions • Minimally invasive and robotic approaches to risk-reducing gynecologic surgery• Health disparities and barriers to accessing risk-reducing surgery in minoritized and underserved populations• The impact of Medicaid expansion and insurance policy on surgical uptake and gynecologic oncology outcomes• Cascade genetic testing, familial disclosure, and associated implications for gynecologic surgical decision-making• Digital health, generative AI–enabled tools, and technology-assisted platforms for hereditary cancer risk assessment or surgical counseling• Patient perspectives, shared decision-making, and psychosocial considerations surrounding risk-reducing gynecologic surgery• Germline and somatic profiling to guide surgical management in hereditary gynecologic cancer syndromes• Multidisciplinary care pathways integrating genetics, gynecologic oncology, and minimally invasive surger• Risk-reducing mastectomy as a concurrent consideration in hereditary syndrome carriers undergoing gynecologic surgery Topic editors: Muhammad Danyal Ahsan, Emily Webster, Murtaza Qazi Source: https://www.frontiersin.org/research-topics/83106/risk-reducing-gynecologic-and-breast-surgery-outcomes-access-and-innovation-in-hereditary-cancer-syndromes