Advertisement
Editorial| Volume 132, ISSUE 2, P261-263, February 2014

Download started.

Ok

Risk reducing salpingo-oophorectomy for BRCA mutation carriers: Twenty years later

      It has been twenty years since the region of the BRCA1 mutation was identified on chromosome 17q. There are now over 3000 risk reducing salpingo-oophorectomy (RRSO) cases reported and an estimated 150 cases describing unsuspected cancers of the ovaries and tubes or in situ lesions. Connor et al. in their current study add to the literature on RRSO outcomes [
      • Connor J.R.
      • Meserve E.
      • Pizer E.
      • Garber J.
      • Roh M.
      • Urban N.
      • et al.
      Outcome of unexpected adnexal neoplasia discovered during risk reduction salpingo-oophorectomy in women with germ-line BRCA1 or BRCA2 mutations.
      ]. They report on 345 cases of RRSO in BRCA mutation carriers from a single institution, finding a HGTIN/cancer rate of 5.4%, 9.2% in BRCA1 and 3.4% in BRCA2. Mean age of neoplasia was 54.4 years which was higher than those without neoplasia (47.8 years). The authors then present 29 cases collected from 3 institutions of HGTIN/cancer followed for a median of 5 years. 1/11 HGTIN recurred and 3/18 invasive cancers recurred (17%).
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gynecologic Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Connor J.R.
        • Meserve E.
        • Pizer E.
        • Garber J.
        • Roh M.
        • Urban N.
        • et al.
        Outcome of unexpected adnexal neoplasia discovered during risk reduction salpingo-oophorectomy in women with germ-line BRCA1 or BRCA2 mutations.
        Gynecol Oncol. 2014; 133: 280-286
        • Finch A.
        • Beiner M.
        • Lubinski J.
        • Lynch H.T.
        • Moller P.
        • Rosen B.
        • et al.
        Salpingo-429 oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in 430 women with a BRCA1 or BRCA2 Mutation.
        JAMA. 2006; 296: 185-192
        • Manchanda R.
        • Abdelraheim A.
        • Johnson M.
        • Rosenthal A.N.
        • Benjamin E.
        • Brunell C.
        • et al.
        Outcome of risk-reducing salpingo-oophorectomy in BRCA carriers and women of 408 unknown mutation status.
        BJOG. 2011; 118: 814-824
        • Mingels M.J.
        • Roelofsen T.
        • van der Laak J.A.
        • de Hullu J.A.
        • van Ham M.A.
        • Massuger L.F.
        • et al.
        Tubal epithelial lesions in salpingo-oophorectomy specimens of BRCA-mutation carriers and controls.
        Gynecol Oncol. 2012; 127: 88-93
        • Powell C.B.
        • Chen L.M.
        • McLennan J.
        • Crawford B.
        • Zaloudek C.
        • Rabban J.T.
        • et al.
        Risk-reducing salpingo-oophorectomy (RRSO) in BRCA mutation carriers: experience with a consecutive series of 111 patients using a standardized surgical–pathological protocol.
        Int J Gynecol Cancer. 2011; 21: 846-851
        • Powell C.B.
        • Swisher E.M.
        • Cass I.
        • McLennan J.
        • Norquist B.
        • Garcia R.L.
        • et al.
        Long term follow up of BRCA1 and BRCA2 mutation carriers with unsuspected neoplasia identified at risk reducing salpingo-oophorectomy.
        Gynecol Oncol. 2013; 129: 364-371
        • Manchanda R.
        • Drapkin R.
        • Jacobs I.
        • Menon U.
        The role of peritoneal cytology at risk reducing salpingo-oophorectomy (RRSO) in women at increased risk of familial ovarian/tubal cancer.
        Gynecol Oncol. 2012; 124: 185-191
        • Reitsma W.
        • de Bock G.H.
        • Oosterwijk J.C.
        • Bart J.
        • Hollema H.
        • Mourits M.J.
        Support of the ‘fallopian tube hypothesis’ in a prospective series of risk-reducing salpingo-oophorectomy specimens.
        Eur J Cancer. 2013; 49: 132-141
        • Wethington S.L.
        • Park K.J.
        • Soslow R.A.
        • Kauff N.D.
        • Brown C.L.
        • Dao F.
        • et al.
        Clinical outcome of isolated serous tubal intraepithelial carcinomas (STIC).
        Int J Gynecol Cancer. 2013; 23: 1603-1611
        • Carcangiu M.L.
        • Peissel B.
        • Pasini B.
        • Spatti G.
        • Radice P.
        • Manoukian S.
        Incidental carcinomas in prophylactic specimens in BRCA1 and BRCA2 germ-line mutation carriers, with emphasis on fallopian tube lesions: report of 6 cases and review of the literature.
        Am J Surg Pathol. 2006; 30: 1222-1230
        • Finch A.
        • Shaw P.
        • Rosen B.
        • Murphy J.
        • Narod S.A.
        • Colgan T.J.
        Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCA1 and BRCA2 carriers.
        Gynecol Oncol. 2006; 100: 58-64
        • Colgan T.J.
        • Murphy J.
        • Cole D.E.
        • Narod S.
        • Rosen B.
        Occult carcinoma in prophylactic oophorectomy specimens: prevalence and association with BRCA germline mutation status.
        Am J Surg Pathol. 2001; 25: 1283-1289
        • Deligdisch L.
        • Gil J.
        • Kerner H.
        • et al.
        Ovarian dysplasia in prophylactic oophorectomy specimens: cytogenetic and morphometric correlations.
        Cancer. 1999; 86: 1544-1550
        • Olivier R.I.
        • van Beurden M.
        • Lubsen M.A.
        • Rookus M.A.
        • Mooij T.M.
        • van de Vijver M.J.
        • et al.
        Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up.
        Br J Cancer. 2004; 90: 1492-1497
        • Meeuwissen P.A.
        • Seynaeve C.
        • Brekelmans C.T.
        • et al.
        Outcome of surveillance and prophylactic salpingo-oophorectomy in asymptomatic women at high risk for ovarian cancer.
        Gynecol Oncol. 2005; 97: 476-482
        • Schmeler K.
        • Sun C.
        • Bodurka D.
        • White K.
        • Soliman P.
        • Uyei A.
        • et al.
        Prophylactic bilateral salpingo-oophorectomy compared with surveillance in women with BRCA mutations.
        Obstet Gynecol. 2006; 108: 515-520
        • Laki F.
        • Kirova Y.
        • This P.
        • Asselain B.
        • Sastre X.
        • Stoppa-Lyonnet D.
        • et al.
        Prophylactic salpingo-oophorectomy in a series of 89 women carrying a BRCA1 or a BRCA2 mutation 1790.
        Cancer. 2007; 109: 1784-1790
        • Domchek S.
        • Friebel T.
        • Garber J.
        • Isaacs C.
        • Matloff E.
        • Eeles R.
        • et al.
        Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers.
        Breast Cancer Res Treat. 2010; 124: 195-203
        • Powell C.B.
        • Littell R.
        • Hoodfar E.
        • Sinclair F.
        • Pressman A.
        Does the diagnosis of breast or ovarian cancer trigger referral to genetic counseling?.
        Int J Gynecol Cancer. 2013; 23: 431-436