목적: Most BRCA1/2 carriers do not undergo risk-reducing salpingo-oophorectomy (RRSO) by the recommended age of 40. We analyzed the mean age of RRSO in BRCA mutation carriers with a history of breast cancer and estimated the prevalence of tubal intraepithelial lesions and occult invasive cancer in RRSO specimens. 방법: We retrospectively reviewed breast cancer patients identified as BRCA mutation carriers who underwent RRSO at Asan Medical Center, Seoul, Korea, from 2010 to 2014. From 2013, both fallopian tubes of all cases were examined and immunohistochemically (IHC) stained according to the SEE/FIM protocol. 결과: RRSO was performed in 63 patients, 27 in 2010–2012 and 36 in 2013–2014. There were 38 BRCA1 and 25 BRCA2 mutation carriers and the median age at RRSO was 46.5 years (32–73 years). Of the 63 patients, 13 (20.6%) underwent RRSO before 40 years. Occult invasive cancer was detected in 8 patients, of ovarian origin in 5 and of tubal origin in 3. All occult invasive cancer cases with metastasis were detected in patients older than 40 years. Of the 36 patients from the 2013–2014 cohort, 7 showed p53 overexpression, 1 showed Ki-67 overexpression, 2 showed serous tubal intraepithelial carcinoma, and 3 showed occult cancer according to the SEE-FIM protocol. The detection rate of premalignant lesions or cancer was 36.1% (13/36). In the analysis according to age, premalignant lesions were more common in BRCA 1 mutation carriers younger than 40 years old (66.7% vs 20.0%). In BRCA 2 mutation carriers, premalignant lesions were only detected in those older than 40 years of age, indicating the possible faster occurrence of premalignant lesions in BRCA1 mutation carriers. 결론: Many patients still tend to delay RRSO until after they are 40 years old. Our findings support the significance of RRSO before the age of 40 in germline BRCA mutation carriers.