Epithelial Tumor of the Ovary of Borderline Malignancy

A Epithelial tumor of the ovary of borderline malignancy (also called a “tumor of low malignant potential”) is an epithelial ovarian growth that shows abnormal cell changes under the microscope but does not invade surrounding tissue the way classic cancer does. It sits between benign and invasive cancer on the behavior spectrum. Most borderline tumors are serous or mucinous types. They are often found at an early stage, grow slowly, and have an excellent long-term survival, especially when fully removed with surgery. Recurrence can happen, so careful follow-up is important, but life-threatening spread is uncommon compared with invasive ovarian cancer. Cancer.gov+2PMC+2 Because these tumors typically lack destructive invasion, treatment is usually surgery-focused (to remove the tumor and check for any implants) and chemotherapy is generally not routinely required—it is reserved for select advanced or recurrent situations. Young patients who wish to keep fertility often can have “fertility-sparing surgery” with close monitoring. Cancer.gov+2annalsofoncology.org+2

A “borderline” epithelial tumor of the ovary is an abnormal growth made from the surface lining cells of the ovary. Doctors also call it a “low malignant potential” tumor. This tumor shows extra cell growth and mild-to-moderate atypia (cells look a bit abnormal). But it does not show destructive invasion into the surrounding ovarian tissue like a true cancer does. Because there is no destructive invasion, these tumors act less aggressively than ovarian cancers. Most people are diagnosed at an early stage, and long-term survival is excellent. Surgery is the main treatment, and many patients need no chemotherapy. Even so, careful diagnosis and follow-up are important because a small number can recur, spread on the peritoneal surfaces as “implants,” or (rarely) evolve into an invasive low-grade carcinoma over time. Cancer.gov+2PMC+2

A borderline ovarian tumor is a growth that starts from the surface (epithelial) cells of the ovary. Under the microscope, the cells look abnormal and grow more than normal cells, but they do not show the destructive, deep-invading behavior seen in “true” ovarian cancers. Doctors therefore call them “low malignant potential.” These tumors most often affect younger people than typical ovarian cancer, have an excellent long-term outlook, and are usually treated with surgery alone. Chemotherapy or targeted drugs are not routinely needed unless there is spread with invasive features, transformation to an invasive cancer, or unusual high-risk findings. Survival is very high, especially when found early, and many patients can keep fertility with carefully planned surgery. MDPI+3Cancer.gov+3Cancer.gov+3

Other names

Doctors and pathologists use several names for the same group of tumors. Older terms still appear in charts and papers.

• “Borderline ovarian tumor” (BOT).

• “Tumor of low malignant potential” (LMP).

• “Atypical proliferative tumor” (used with the cell type, e.g., “atypical proliferative serous tumor”).
  All these names describe ovarian epithelial tumors that have more growth than a benign cyst but lack destructive stromal invasion. The World Health Organization (WHO 2020) accepts “borderline tumor” as the standard term. PMC+1

Types

Borderline tumors are grouped by the cell type that they resemble. The main subtypes are:

1. Serous borderline tumor (SBT), including a micropapillary variant. Serous is the commonest subtype and may have peritoneal “implants” that are usually non-invasive. PMC+2PMC+2

2. Mucinous borderline tumor (MBT). Often very large, may be intestinal-type or Müllerian-type, and sometimes shows “intraepithelial carcinoma” without invasion. PMC+1

3. Endometrioid borderline tumor. Less common; often linked with endometriosis and has an excellent outlook. Cancer.gov

4. Seromucinous borderline tumor (mixed epithelium/endocervical-type); often associated with endometriosis. cancerdiagnosisprognosis.org

5. Clear cell borderline tumor (very rare). ScienceDirect

6. Brenner (transitional-type) borderline tumor (rare). (Mentioned in WHO/consensus classifications as a rare borderline form.) RSNA Publications

Borderline tumors show epithelial proliferation and atypia without destructive stromal invasion. Some serous tumors show “microinvasion” (tiny foci that still do not behave like invasive cancer). The presence or absence of peritoneal “implants” and whether they are non-invasive vs invasive influences prognosis and follow-up. PMC+2CAP Documents+2

---

Causes / risk factors

No single cause explains all cases. These are risk factors or associations that raise or lower risk; having one does not mean someone will get a tumor.

1. Many lifetime ovulations. More ovulations may slightly raise risk; fewer ovulations may lower risk. (Concept used across epithelial ovarian tumors.) NCBI

2. Nulliparity (never pregnant). Similar reasoning: more ovulatory cycles. NCBI

3. Infertility or subfertility. Some studies show association with epithelial tumors overall; the link to borderline tumors is described in reviews. PubMed

4. Endometriosis. Especially linked with endometrioid and seromucinous borderline tumors. cancerdiagnosisprognosis.org

5. Smoking. Associated with mucinous ovarian tumors (including borderline). PMC

6. Hormonal factors that increase ovulation (e.g., early menarche, late menopause) may raise lifetime ovulations. NCBI

7. Oral contraceptive pill use (long term). This reduces risk for epithelial ovarian tumors by suppressing ovulation; protective effect extends to some borderline tumors. NCBI

8. Family history of ovarian tumors. Strongest for invasive cancers; borderline tumors usually lack strong hereditary links but family clustering can occur. NCBI

9. Genetic changes in the tumor such as KRAS mutations (especially mucinous borderline). These are tumor events, not inherited risk in most cases. PMC

10. BRAF mutations (often in serous borderline tumors). Again, this is a tumor change that helps explain behavior. PMC

11. Low-grade serous pathway biology. Serous borderline tumors sit on the pathway toward low-grade serous carcinoma in a small minority. Cancer.gov

12. Prior pelvic inflammatory disease. Non-specific pelvic inflammation has been studied as a risk factor for epithelial tumors in general. Cureus

13. Obesity. A general risk factor for several gynecologic tumors; evidence in borderline tumors is mixed. MDPI

14. Environmental factors (talc, etc.) have been debated in epithelial ovarian cancer; evidence is mixed and not specific to borderline tumors. MDPI

15. Age (younger than invasive cancer). Borderline tumors tend to occur about a decade earlier than invasive epithelial ovarian cancer. acmcasereport.org

16. Endometriosis-related oxidative stress (proposed mechanism for Müllerian/seromucinous/endometrioid forms). cancerdiagnosisprognosis.org

17. Mucinous neoplasia sequence within large multilocular cysts (KRAS-driven progression). PMC

18. Hormonal stimulation/ovulation induction drugs. Evidence is inconsistent; if present, the effect is small. MDPI

19. Prior benign ovarian cysts (especially mucinous or serous); some borderline tumors may arise from pre-existing cystadenomas. Modern Pathology

20. Geographic and diagnostic factors. Improved imaging and pathology review increase detection of borderline tumors at early stage. Cancer.gov

---

Symptoms

Not everyone has symptoms. Many tumors are found during an ultrasound for another reason.

1. Bloating or fullness. The ovary can enlarge and hold fluid, causing a swollen feeling. MDPI

2. Lower abdominal or pelvic pain. Stretching of the ovarian capsule or pressure on nearby organs can hurt. MDPI

3. A feeling of pelvic pressure. The mass can press on the bladder, bowel, or uterus. MDPI

4. Urinary frequency or urgency. Pressure on the bladder makes you go more often. MDPI

5. Constipation or change in bowel habits. A large cyst can press on the rectum or sigmoid colon. MDPI

6. Early satiety. You feel full after small meals when the mass crowds the stomach. MDPI

7. Increase in waist size or clothes feeling tight. Due to a growing mass or fluid. MDPI

8. Menstrual changes. Usually mild and non-specific; more common with hormone-active tumors, but any pelvic process can disrupt cycles. MDPI

9. Dyspareunia (pain with intercourse). Pelvic mass can cause tenderness. MDPI

10. Back pain. From pelvic or lower abdominal pressure. MDPI

11. Acute pelvic pain from torsion or rupture. Any cystic ovarian mass can twist or leak. Seek urgent care. MDPI

12. Breathlessness with large ascites (uncommon). Borderline tumors less often cause major fluid, but it can happen. Cancer.gov

13. Unexpected weight change. Usually from fluid or mass effect. MDPI

14. Infertility workup finding. Many are discovered during evaluation for infertility. PubMed

15. No symptoms at all. Many are incidental on ultrasound or during surgery for another reason. Cureus

Diagnostic tests

A) Physical examination

1. General exam and vital signs. Checks overall health, pain level, and signs of acute complications. It guides urgency rather than giving a final diagnosis. MDPI

2. Abdominal palpation. A large, smooth, mobile cystic mass may be felt in the lower abdomen. Tenderness can suggest torsion or rupture. MDPI

3. Pelvic bimanual exam. The clinician feels the uterus and adnexa by hand. This can detect a mass, mobility, and tenderness, but small tumors can be missed. MDPI

4. Rectovaginal exam (when needed). Helps assess cul-de-sac nodularity or posterior masses and plan surgery. MDPI

5. Assessment for ascites or hernia. Fluid wave or shifting dullness suggests ascites; also rule out other causes of abdominal swelling. MDPI

B) Manual / bedside tests

6. Pregnancy test (urine/serum hCG). Always confirm non-pregnant status before imaging decisions in reproductive-age patients and to exclude ectopic pregnancy. MDPI

7. Pain provocation and torsion signs at bedside. Point tenderness with sudden severe pain can signal torsion—an emergency for any adnexal mass. MDPI

8. Risk-of-malignancy scoring using clinical data. Simple bedside scores combine menopausal status, CA-125, and ultrasound features to guide referral. They triage risk; they do not diagnose borderline histology. Cureus

9. Documentation of mass size with a tape measure over weeks (in giant cysts). Crude but sometimes used when access to imaging is limited; imaging is preferred. MDPI

10. Pre-operative ECG (supportive). Not diagnostic of the tumor itself, but important for anesthesia planning before surgery. MDPI

C) Laboratory and pathological tests

11. CA-125 blood test. This marker can be normal or only mildly raised in borderline tumors. It is not a stand-alone diagnostic test, but can support risk triage and post-op follow-up. Elevation is more common in serous than mucinous borderline tumors. PMC+2ScienceDirect+2

12. Other tumor markers by subtype. CA19-9 and CEA may rise with mucinous tumors; HE4 may be used with CA-125 in some algorithms (ROMA). Use is adjunctive only. Ovarian Cancer Research Alliance

13. CBC and chemistry panel. Baseline tests for anemia, infection, or renal function; helpful for surgical readiness. MDPI

14. Pre-op typing and crossmatch (if large mass). Planning for surgery where bleeding risk exists. MDPI

15. Intraoperative frozen section (pathology). During surgery, the pathologist examines a small tissue slice while you are still asleep. This helps decide how much surgery to do. Accuracy is high for many tumors but limited in very large mucinous tumors with mixed areas. cytojournal.com

16. Definitive histopathology on formalin-fixed tissue. This makes the final diagnosis of “borderline” by showing epithelial proliferation and atypia without destructive stromal invasion; it also reports microinvasion, implants, and subtype. Modern Pathology

17. Assessment of peritoneal implants and lymph nodes (pathology). In serous borderline tumors, implants are usually non-invasive; invasive implants or true low-grade carcinoma change prognosis and follow-up. Lippincott+1

D) Electrodiagnostic tests

18. Electrocardiogram (ECG). Again, this is for pre-operative safety, not to detect the tumor. It checks heart rhythm before anesthesia. (Included here to reflect the requested category; it does not diagnose ovarian tumors.) MDPI

E) Imaging tests

19. Transvaginal ultrasound (TVUS). First-line test. Borderline tumors often appear as complex cystic masses with thin septations and papillary projections. Doppler can show vascularity in the projections. Ultrasound helps estimate risk and plan surgery. MDPI

20. Transabdominal ultrasound. Adds a wider field for very large or high masses. MDPI

21. Color Doppler ultrasound. Increased flow in papillary areas supports neoplastic epithelium but is not specific. Cureus

22. MRI of the pelvis. Excellent for defining internal architecture, papillary nodules, hemorrhage, and mucin. MRI features can suggest a borderline pattern and help separate mucinous from serous. RSNA Publications

23. CT scan of abdomen and pelvis. Useful for large masses, suspected spread, surgical planning, and to look for peritoneal implants. MDPI

24. Chest imaging (X-ray or CT) if spread suspected. Checks for pleural effusions or distant disease in complex cases. MDPI

25. PET-CT (select cases). Sometimes used when the diagnosis is unclear after other imaging, but it is not routinely needed in typical borderline tumors. MDPI

Putting it together: No blood test or scan can prove a “borderline” tumor. Only the pathology on the removed tissue can confirm the diagnosis and the subtype. Modern Pathology

Core treatment

For most patients, the main treatment is surgery tailored to stage and life plans (for example, cyst removal or one ovary removed to preserve fertility). Routine “adjuvant” chemotherapy is not indicated for typical borderline tumors after proper surgery. Follow-up with exams and imaging is important because recurrences can happen, but they are often manageable. Cancer.gov+2Obstetrics & Gynecology+2

---

Non-pharmacological treatments (therapies & others)

Below are practical, plain-English options. For each: description, purpose, and “how it works” (mechanism). These complement—not replace—surgeon-led care.

1. Fertility-sparing surgery (FSS).
   Description: Keyhole (laparoscopic) or open surgery to remove the cyst (cystectomy) or the affected ovary and tube (unilateral salpingo-oophorectomy) while keeping the uterus and, if safe, the other ovary.
   Purpose: Treat the tumor while preserving the ability to become pregnant.
   Mechanism: Physically removes visible tumor and allows complete staging; preserves reproductive organs when oncologically safe. PMC+2MDPI+2

2. Comprehensive surgical staging (when indicated).
   Description: Careful inspection of the abdomen/pelvis, washings, removal of the omentum, selective peritoneal biopsies, and resection of visible implants.
   Purpose: Accurately determine spread and guide follow-up.
   Mechanism: Direct visualization and sampling detect microscopic disease and risk features. exxcellence.org+1

3. Laparoscopic approach (minimally invasive).
   Description: Surgery through small cuts using a camera.
   Purpose: Faster recovery, less pain, same oncologic goals when performed by experienced teams.
   Mechanism: Achieves tumor removal and staging with less tissue trauma; must avoid cyst rupture. MDPI

4. Open surgery (laparotomy).
   Description: Traditional larger incision when disease is complex or extensive.
   Purpose: Maximizes surgical control for bulky or difficult disease.
   Mechanism: Provides wider access to remove tumor completely and safely. JNCCN

5. Omentectomy (selective).
   Description: Removal of the apron-like fatty tissue in the abdomen.
   Purpose: Staging and clearing implants if present.
   Mechanism: Eliminates microscopic or visible disease sites used in staging algorithms. exxcellence.org

6. Appendectomy for mucinous borderline tumors (case-by-case).
   Description: Removal of the appendix when mucinous type or suspicious findings.
   Purpose: Rule out an appendiceal source and prevent confusion/recurrence.
   Mechanism: Eliminates potential primary or synchronous mucinous disease. PMC

7. Fertility preservation counseling.
   Description: Pre-op counseling on egg/embryo freezing when ovarian tissue may be lost.
   Purpose: Protect future family-building options.
   Mechanism: Cryopreservation before surgery or soon after balances oncologic safety with fertility goals. Thieme

8. Genetic risk assessment (selective).
   Description: Review family history; test if history suggests hereditary ovarian/breast cancer syndromes.
   Purpose: Clarify inherited risk and tailor surveillance for patient and relatives.
   Mechanism: Identifies high-risk genes; note that borderline and mucinous tumors are not typically BRCA-related. Society of Gynecologic Oncology

9. Structured surveillance plan.
   Description: Scheduled pelvic exams, ultrasound, and/or CT/MRI based on stage and pathology.
   Purpose: Catch recurrences early and reassure when stable.
   Mechanism: Periodic imaging/exam detects new lesions before symptoms. Cancer.gov

10. Pelvic floor and core physical therapy (post-op recovery).
    Description: Guided exercises after surgery.
    Purpose: Reduce pain, speed return to normal activity, support sexual function.
    Mechanism: Improves strength, flexibility, and scar mobility after abdominal/pelvic surgery. NCCN

11. Nutrition counseling (oncology-informed).
    Description: Dietitian review of balanced diet, adequate protein, iron, and fiber.
    Purpose: Support healing and energy; manage post-op bowel function.
    Mechanism: Adequate micronutrients and fiber aid tissue repair and gut motility. NCCN

12. Psychological support & survivorship care.
    Description: Counseling, support groups, anxiety and body-image resources.
    Purpose: Reduce distress; improve adherence to follow-up.
    Mechanism: Cognitive-behavioral and peer support lower anxiety and improve quality of life. NCCN

13. Return-to-activity program.
    Description: Stepwise increase in walking, light strength, and stretching.
    Purpose: Prevent deconditioning, clots, and stiffness after surgery.
    Mechanism: Gradual loading improves circulation and tissue remodeling. NCCN

14. Management of surgical menopause (if both ovaries removed).
    Description: Discuss symptoms, non-hormone measures; individualized decisions on hormones if appropriate.
    Purpose: Control hot flashes, bone loss, and mood changes.
    Mechanism: Lifestyle steps and, when suitable, medications address estrogen withdrawal effects. NCCN

15. Sexual health rehabilitation.
    Description: Lubricants, dilators, counseling, and pelvic PT as needed.
    Purpose: Restore comfortable intimacy.
    Mechanism: Addresses dryness, pelvic floor tension, and anxiety after pelvic surgery. NCCN

16. Smoking cessation.
    Description: Counseling and tools to quit.
    Purpose: Improve wound healing and long-term health.
    Mechanism: Reduces vasoconstriction and inflammation that impair recovery. NCCN

17. Vaccination and infection prevention (peri-op).
    Description: Stay up-to-date; follow peri-op infection-prevention guidance.
    Purpose: Lower infection risk pre/post-op.
    Mechanism: Immune priming and sterile technique reduce complications. NCCN

18. Bone health support (if ovarian function lost).
    Description: Calcium, vitamin D from diet, weight-bearing exercise; DEXA when indicated.
    Purpose: Prevent bone thinning.
    Mechanism: Nutrients and loading stimulate bone remodeling. NCCN

19. Bowel management plan (post-op).
    Description: Fiber, fluids, gentle laxatives if needed.
    Purpose: Prevent constipation after anesthesia/opioids.
    Mechanism: Restores motility and softens stool. NCCN

20. Sunrise-style survivorship checklist.
    Description: A simple list covering symptoms to watch, appointment dates, lifestyle goals.
    Purpose: Keep follow-up organized and reduce missed warning signs.
    Mechanism: Structured reminders improve adherence and early reporting. NCCN

---

Drug treatments

Important context first: For typical borderline ovarian tumors, there is no routine role for chemotherapy or targeted therapy after adequate surgery. When a patient later develops recurrent disease with invasive features or transformation to low-grade serous carcinoma (LGSC), clinicians may consider endocrine (hormone) therapy; in select invasive settings, other systemic drugs may be used according to ovarian cancer guidelines—not as standard therapy for borderline disease itself. Off-label use should be guided by a gynecologic oncologist. Cancer.gov+2Obstetrics & Gynecology+2

Below, I list commonly referenced agents with FDA labels (accessdata.fda.gov) for transparency. Where applicable, I note that use in borderline tumors is off-label and primarily considered when disease behaves like LGSC or an invasive epithelial ovarian cancer. Always individualize dosing and timing to the treating team’s plan.

Endocrine (hormonal) options often used off-label in LGSC-like behavior

1. Letrozole (aromatase inhibitor) — Off-label for BOT/LGSC.
   Class: Aromatase inhibitor. Typical dosing used in practice: 2.5 mg orally once daily.
   Purpose/Mechanism: Lowers estrogen, which can slow growth of estrogen-sensitive serous tumors.
   Key note: Evidence supports activity in recurrent LGSC; not an FDA-approved indication for BOT. ScienceDirect+1

   • FDA label reference (drug info): accessdata.fda.gov (Letrozole). NCCN

2. Anastrozole (AI) — Off-label.
   Dosing often used: 1 mg orally daily.
   Mechanism/Purpose: Same as letrozole; blocks aromatase to reduce estrogen. lgsoc.org
   • FDA label reference: accessdata.fda.gov (Anastrozole).

3. Exemestane (AI) — Off-label.
   Dosing often used: 25 mg orally daily.
   Mechanism: Irreversible aromatase inactivation. lgsoc.org
   • FDA label reference: accessdata.fda.gov (Exemestane).

4. Tamoxifen (SERM) — Off-label.
   Dosing often used: 20 mg orally daily.
   Mechanism: Blocks estrogen receptors in tumor tissue. Note: Sometimes used for recurrent LGSC. PMC
   • FDA label reference: accessdata.fda.gov (Tamoxifen).

5. Megestrol acetate (progestin) — Off-label.
   **Dosing varies (e.g., 40–160 mg/day)*.
   Mechanism: Progestin-mediated anti-proliferative effects in estrogen-responsive tumors.
   • FDA label reference: accessdata.fda.gov (Megestrol).

6. Goserelin (GnRH agonist) — Off-label.
   Dosing often used: 3.6 mg SC every 28 days.
   Mechanism: Suppresses ovarian estrogen production via pituitary down-regulation.
   • FDA label reference: accessdata.fda.gov (Goserelin).

7. Leuprolide (GnRH agonist) — Off-label.
   Dosing: e.g., 3.75 mg IM monthly.
   Mechanism: Ovarian suppression lowers estrogen drive.
   • FDA label reference: accessdata.fda.gov (Leuprolide).

Targeted/other agents used for invasive epithelial ovarian cancers (not standard for BOT)

8. Bevacizumab (anti-VEGF) — Not for typical BOT; used in invasive ovarian cancer.
   Dosing: Commonly 15 mg/kg IV q3w in ovarian cancer regimens.
   Mechanism: Blocks VEGF to reduce tumor blood supply.
   • FDA ovarian label includes certain ovarian cancer settings; not for BOT. NCBI

9. PARP inhibitors (e.g., olaparib, niraparib) — For specific invasive ovarian cancer indications; not for BOT.
   Mechanism: Exploit DNA repair defects (e.g., BRCA) to kill tumor cells.
   • FDA labels exist for EOC maintenance/recurrence; not BOT. NCBI

10. Trametinib (MEK inhibitor) — Off-label in LGSC; not FDA-approved for LGSC/BOT.
    Mechanism: Inhibits MEK in MAPK pathway; activity shown in recurrent LGSC trials.
    • FDA label exists for other cancers; not BOT. ScienceDirect

11. Selumetinib (MEK inhibitor) — Investigational/off-label context in LGSC.
    Mechanism: Similar to trametinib; limited approvals in other settings.
    • See LGSC literature; no BOT indication. PMC

12. Letrozole + CDK4/6 inhibitor combinations (research/clinic-specific) — Off-label.
    Mechanism: Estrogen suppression plus cell-cycle blockade may slow ER-positive low-grade serous growth in trials/series.
    • Expert consensus discusses endocrine options in LGSC; not standard for BOT. international-journal-of-gynecological-cancer.com

Supportive/adjunct medications (symptom control around surgery; FDA-labeled for their uses, not for BOT itself)

13. Acetaminophen — pain/fever control; opioid-sparing. (FDA OTC labeling available.)

14. NSAIDs (e.g., ibuprofen, naproxen) — anti-inflammatory, post-op pain. (FDA labels.)

15. Ondansetron — antiemetic for post-op or medication-related nausea. (FDA label.)

16. Metoclopramide — antiemetic/anti-gastroparesis if needed post-op. (FDA label.)

17. Stool softeners (docusate) / osmotic laxatives (PEG) — prevent constipation after anesthesia/opioids. (FDA labels.)

18. Proton-pump inhibitor (e.g., omeprazole) — protects stomach during NSAID use if indicated. (FDA label.)

19. Low-molecular-weight heparin — peri-op clot prevention per risk. (FDA labels for anticoagulation.)

20. Topical/local anesthetics — part of multimodal pain plans after laparoscopy. (FDA labels.)

Drug labels for the above can be accessed on accessdata.fda.gov; specific indications and safety are detailed there. In borderline ovarian tumors, these agents are used to manage symptoms or, in the case of endocrine therapy, off-label when the disease behaves more like LGSC; this should be individualized by a gynecologic oncologist. Cancer.gov+1

---

Dietary molecular supplements

No supplement has proven to treat a borderline ovarian tumor. Nutrition choices aim to support recovery and overall health. Always discuss supplements with your care team to avoid interactions.

1. Protein (whey or plant protein if diet is insufficient).
   Dose: Typically 20–30 g per serving as needed to meet daily protein goals.
   Function/Mechanism: Supplies amino acids for tissue repair after surgery and supports lean mass during recovery; works by providing building blocks for collagen and muscle. NCCN

2. Omega-3 fatty acids (fish oil or algal DHA/EPA).
   Dose: Commonly 1–2 g/day EPA+DHA (check interactions).
   Function/Mechanism: May modestly reduce post-op inflammation and support cardiovascular health; incorporated into cell membranes, influencing inflammatory mediators. NCCN

3. Vitamin D (if deficient).
   Dose: Per lab-guided plan (often 1,000–2,000 IU/day; higher if deficient under supervision).
   Function/Mechanism: Aids calcium balance and bone health, especially if ovaries removed; acts via vitamin D receptor to support bone mineralization. NCCN

4. Calcium (diet first).
   Dose: Aim ~1,000–1,200 mg/day total from food + supplements if needed.
   Function/Mechanism: Supports bone strength by providing mineral substrate for bone matrix. NCCN

5. Iron (only if anemic or low).
   Dose: Guided by labs (e.g., 18–65 mg elemental Fe/day).
   Function/Mechanism: Replenishes hemoglobin; improves energy by restoring oxygen-carrying capacity. NCCN

6. B-complex (if intake is poor).
   Dose: Standard daily B-complex.
   Function/Mechanism: Supports energy metabolism and red-blood-cell formation. NCCN

7. Fiber (psyllium if diet lacks).
   Dose: 5–10 g/day psyllium with water.
   Function/Mechanism: Softens stool and normalizes transit after surgery; forms gel that retains water. NCCN

8. Probiotics (strain-specific).
   Dose: As per product; discuss peri-op timing.
   Function/Mechanism: May help bowel regularity and antibiotic-associated symptoms by restoring microbiome balance. NCCN

9. Magnesium (for constipation/muscle cramps).
   Dose: 200–400 mg/day (watch kidney function).
   Function/Mechanism: Osmotic laxative effect (citrate) and cofactor in muscle/nerve function. NCCN

10. Multivitamin (diet insurance).
    Dose: Once daily standard formula.
    Function/Mechanism: Addresses small micronutrient gaps during recovery; not a treatment for the tumor. NCCN

---

Drugs labeled as immunity boosters / regenerative / stem-cell related

There are no FDA-approved “immune boosters” or stem-cell drugs to treat borderline ovarian tumors. Below are contexts sometimes discussed in survivorship; none treats BOT, and all should be clinician-guided:

1. Influenza & routine vaccines (clinical prevention, not tumor therapy).
   Dose: Per national schedules.
   Function/Mechanism: Prime adaptive immunity against infections during/after surgery; reduces illness burden that can delay recovery. NCCN

2. Vitamin D (immunity-support role in deficiency).
   Dose: Per labs.
   Mechanism: Modulates innate/adaptive immunity via VDR pathways; not cancer therapy. NCCN

3. Zinc (short course for deficiency only).
   Dose: Commonly 8–15 mg/day elementally unless treating deficiency.
   Mechanism: Cofactor for immune enzymes; excessive dosing can harm copper balance. NCCN

4. Exercise “as medicine.”
   Dose: 150 minutes/week moderate activity + 2 strength days if cleared.
   Mechanism: Enhances immune surveillance, reduces inflammation, and improves quality of life—behavioral, not pharmacologic. NCCN

5. Avoid unproven stem-cell products.
   Dose: Not applicable.
   Mechanism: Many are unregulated and risky; no evidence for BOT. Follow specialist advice and clinical trials only. Cancer.gov

6. Clinical trials (when appropriate).
   Dose: Protocol-defined.
   Mechanism: Access investigational therapies under oversight; may apply if disease transforms to invasive subtypes. JNCCN

---

Surgeries (procedures & why they’re done)

1. Cystectomy (tumor cyst removed, ovary preserved).
   Why: For small, well-circumscribed lesions in patients desiring fertility; slightly higher local recurrence risk; careful selection needed. MDPI

2. Unilateral salpingo-oophorectomy (remove one ovary + tube).
   Why: Common FSS choice; lowers recurrence risk versus cystectomy while preserving the other ovary and the uterus. PMC

3. Bilateral salpingo-oophorectomy with or without hysterectomy.
   Why: For completed childbearing, bilateral disease, or higher-risk features; reduces recurrence risk the most. exxcellence.org

4. Omentectomy and peritoneal biopsies.
   Why: Staging and clearing visible implants to classify disease accurately. exxcellence.org

5. Appendectomy (mucinous tumors, selective).
   Why: Rule out appendiceal origin and remove a potential source of mucinous disease. PMC

---

Preventions

1. Know your family history and seek counseling when indicated (though BOTs are usually not BRCA-linked). Society of Gynecologic Oncology

2. Don’t ignore persistent pelvic symptoms (bloating, pressure, changes in periods). Early assessment leads to better outcomes. Cancer.gov

3. Regular gynecologic checkups with prompt evaluation of new ovarian cysts that look complex. ACOG

4. Oral contraceptives may reduce ovarian epithelial cancer risk (population data), but decisions must be individualized. NCCN

5. Maintain a healthy weight, move daily, don’t smoke—general cancer-preventive habits. NCCN

6. Manage endometriosis with care (some borderline/endometrioid links discussed in literature). PMC

7. Seek expert surgical care at centers experienced in gynecologic oncology. JNCCN

8. Plan pregnancies and fertility decisions with your team if you carry an adnexal mass. Thieme

9. Adhere to follow-up schedules after surgery to catch recurrences early. Cancer.gov

10. Be cautious with unregulated “cancer cures.” Stick to guideline-based care. Cancer.gov

---

When to see a doctor

Make an appointment promptly if you notice ongoing bloating, pelvic or lower-abdominal pain or pressure, feeling full quickly, urinary urgency, or abnormal bleeding, especially if these symptoms persist for more than a few weeks. If you already had surgery for a borderline tumor, contact your team sooner for any new pelvic pain, a growing abdominal mass, sudden belly swelling, bowel or bladder changes, or unexplained weight loss. These symptoms do not always mean cancer, but they deserve evaluation—earlier review is safer and can prevent complications. Cancer.gov

---

What to eat and what to avoid

Eat more of:

1. Whole foods pattern: vegetables, fruits, whole grains, legumes. Helps bowel regularity and overall recovery. NCCN

2. Lean proteins (fish, poultry, beans, tofu) to meet healing needs. NCCN

3. Healthy fats (olive oil, nuts, seeds) to support energy. NCCN

4. Calcium- and vitamin-D–rich foods (dairy or fortified alternatives) if ovaries removed. NCCN

5. Adequate fluids and fiber for post-op bowel health. NCCN

Limit/avoid:

1. Highly processed foods and excess added sugar that can worsen energy swings and constipation. NCCN
2. Very high-salt meals that can increase bloating. NCCN
3. Alcohol during early recovery or with interacting medicines. NCCN
4. Unverified herbal products that may interact with anesthesia, hormones, or anticoagulants. NCCN
5. Large gas-forming meals right after surgery (adjust as you heal). NCCN

---

FAQs

1. Is a borderline tumor “cancer”?
   It has abnormal growth features but lacks destructive invasion seen in cancer; it sits between benign and malignant. Prognosis is excellent after proper surgery. Cancer.gov

2. What is the usual treatment?
   Surgery tailored to stage and fertility wishes; most do not need chemo afterward. Cancer.gov

3. Can I keep my fertility?
   Often yes—fertility-sparing surgery is widely accepted in appropriate patients, with high survival. PMC

4. What is the chance of recurrence?
   Recurrence can happen, especially after cystectomy, but overall survival remains high; surveillance catches issues early. MDPI

5. Do I need chemotherapy or targeted therapy?
   Usually no. These are reserved for invasive disease, not typical borderline tumors. Cancer.gov

6. Are hormones (like letrozole) used?
   Sometimes, off-label, when disease behaves like low-grade serous carcinoma, especially for recurrence—not routine for classic BOT. PMC

7. Will I need a big incision?
   Many cases can be done laparoscopically; choice depends on tumor size, spread, and surgeon expertise. MDPI

8. What staging is done?
   Washings, omentectomy, selective biopsies, and removal of visible implants help classify spread. exxcellence.org

9. How often are follow-ups?
   Your team sets a schedule of exams and imaging—more frequent early on, then less often if stable. Cancer.gov

10. Can diet or supplements cure it?
    No. Diet supports healing but does not treat the tumor. Use supplements only to correct deficiencies. NCCN

11. Are borderline tumors genetic?
    Most are not linked to BRCA; mucinous and borderline types are generally not part of BRCA-related patterns. Society of Gynecologic Oncology

12. If both ovaries are removed, what about hormones?
    Discuss symptoms and risks with your team; some patients use non-hormone options and, selectively, hormone therapy. NCCN

13. What if I want another opinion?
    Seeing a gynecologic oncologist at a specialized center is encouraged—especially for fertility planning. JNCCN

14. What’s the long-term outlook?
    Excellent; many series show 10–20-year survival rates above 90% overall, with stage-dependent differences. Cancer.gov

15. What if it returns?
    Most recurrences are managed surgically; endocrine therapy may be considered in select LGSC-like settings. Cancer.gov+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: October 30, 2025.

PDF Documents For This Disease Condition References