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A 50-year-old non-Hispanic white Caucasian female was diagnosed with breast cancer and was subsequentlyfound to possess the tumorigenic ataxia telangiectasia mutated (ATM) and PALB2 variants but not the BRCA1 andBRCA2 variants. She visited the gynecologic oncology office for routine counseling about risk-reducing salpingooophorectomy(RRSO). Although the patient was asymptomatic, an adnexal mass was discovered in the physicalexamination performed by palpation. Upon using pre-operative imaging techniques, an 8 cm complex adnexal masswas identified. Her CA-125 level was elevated. She underwent complete cytoreductive surgery. Pathological analysisshowed a stage IC clear cell carcinoma of the left ovary; subsequently, she received 6 cycles of adjuvant chemotherapywith a combination of carboplatin and paclitaxel. The patient exhibited no signs ovarian cancer in a follow-upappointment after 32 months of treatment. However, bilateral RRSO is not recommended for patients positive forATM and PALB2. Breast cancer patients with PALB2 and ATM mutations should extensively discuss the risks andbenefits of RRSO in light of current data.

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