Risk Reducing Salpingectomy With Delayed Oophorectomy as an Alternative to Risk- Reducing Salpingo-oophorectomy in High Risk-Women to Assess the Safety of Prevention - US Cohort Study

Inclusion Criteria:

In order to be eligible to participate in this study, a subject must meet all of the following criteria:

1. Premenopausal women with a documented deleterious mutation in BRCA1, BRCA2, BRIP1,RAD51C, PALB2 and/or RAD51D gene germline mutation.

2. Age 25-40 years for BRCA1 mutation carriers, 25-45 years for BRCA2 and 30-50 yearsfor BRIP1, RAD51C, RAD51D, and PALB2.

• The highest risk for cancer is mediated by the BRCA mutation. If a patient hasmultiple mutations, eligibility will be based on BRCA mutation.

3. No longer requires fallopian tubes for natural childbearing. Future plans for IVFare acceptable.

4. Presence of at least one fallopian tube.

5. Participants may have a personal history of non-ovarian malignancy.

6. Informed consent must be obtained and documented.

Exclusion Criteria:

A potential subject who meets any of the following criteria will be excluded from participation in this study:

1. Postmenopausal status (natural menopause or due to (cancer) treatment)

• A postmenopausal state is defined as no menses for 12 months without analternative medical cause.

• A high follicle stimulating hormone (FSH) level in the postmenopausal range maybe used to confirm a postmenopausal state in women not using hormonalcontraception or hormonal replacement therapy (HRT). However, in the absence of 12 months of amenorrhea, confirmation per the local standard of care can beconsidered.

2. Wish for second stage RRO within two years after RRS (if clear at enrollment)

3. Legally incapable

4. Prior bilateral salpingectomy

5. A personal history of ovarian, fallopian tube, or peritoneal cancer

6. Current clinicals signs, diagnosis, or treatment for malignant disease. AromataseInhibitors, Tamoxifen, and Selective Estrogen Receptor Modulators (SERM) areallowed.