Prophylactic Oopherectomy

Hi,

I'm 40 years old.  Diagnosed with stage II/III infiltrating lobular carcinoma, with vascular invasion, node positive, er/pr-.  Bilateral mastectomies followed by ACT therapy.  No radiation.

I have a family history of three aunts who died before the age of 40 with breast and ovarian cancer.  All Aunts had both cancers at the same time, however, at that time it was not known which was the primary cancer.

Prior my diagnosis of breast cancer at 33, (found lump when I was 28), I had a hysterectomy, however, they left the ovaries.  In January 2000 had reconstructive surgery, (tram flap bilaterally).  

In the past year, symptoms include abdominal pain, bloating, fullness, chronic lower back pain, vaginal discharge (no bleeding), changes in bowel movements and severe gastrointestinal problems.  All tests reveal to date reveal no pathology other than ongoing tests to rule out metastatic disease to bowel.  

I want to have the ovaries removed ASAP, as I feel I'm at a very high risk and have already had breast cancer?

Because I had the tram flap procedure done, does this pose a problem surgically?  Can they remove the ovaries vaginally, or does an incision have to be made.  What are the risks of surgery?

Thank you,

Kathleen Wiseman