Highlights
- •Of 659 women who had preventive oophorectomy, two died of ovarian/peritoneal cancer (0.3%)
- •Of the 1196 women who had ultrasound screening alone, 27 died of ovarian/peritoneal cancer (2.3%)
- •Of the 9 ovarian cancer patients who were diagnosed at preventive oophorectomy the ten year survival was 80%.
- •Of the 42 ovarian cancer patients who were diagnosed by ultrasound screening the ten year survival was 31%.
- •Ultrasound screening is not a viable alternative to preventive salpingo-oophorectomy for women with BRCA1 mutations.
Abstract
Objective
To compare the survival experience of women with a BRCA1 mutation who enrolled in
an ovarian cancer screening program with that of women who opted for preventive oophorectomy.
Methods
We followed 1964 women with a BRCA1 mutation and two ovaries intact in a prospective
study. No women had ovarian cancer or had a bilateral oophorectomy prior to study
initiation. There were 1814 women in the cohort who had at least one screening ultrasound.
They were followed from the date of first ultrasound until the date of preventive
oophorectomy, death or last follow-up. There were 659 women in the cohort who had
preventive oophorectomy. They were followed from the date of preventive oophorectomy
until death or last follow-up.
Results
Among the 1196 women who had one or more ultrasound examinations and no oophorectomy,
there were 73 incident cancers detected and 27 deaths from ovarian/fallopian cancer.
The ten year cumulative risk of death was 2.0%. Among the 659 women who had a preventive
oophorectomy there were 12 incident cancers (9 detected at oophorectomy and 3 in the
follow up period) and two deaths from ovarian cancer. The ten year cumulative risk
of death was 0.5%. The hazard ratio for oophorectomy versus ultrasound was 0.23 (95%
CI: 0.05 to 0.97; p = 0.05).
Conclusion
The survival of women diagnosed with ovarian cancer enrolled in an ultrasound screening
program is relatively poor and screening is not a viable alternative to preventive
oophorectomy.
Keywords
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References
- Hereditary ovarian cancer clinical study group. Age-specific ovarian cancer risks among women with a BRCA1 or BRCA2 mutation.Gynecol. Oncol. 2018; 150: 85-91https://doi.org/10.1016/j.ygyno.2018.05.011
- Hereditary ovarian cancer clinical study group. Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 mutation.JAMA. 2006; 296: 185-192
- Hereditary ovarian cancer in Poland.Int. J. Cancer. 2003; 106: 942-945
- United Kingdom familial ovarian cancer screening study collaborators. Evidence of stage shift in women diagnosed with ovarian cancer during phase II of the United Kingdom familial ovarian cancer screening study.J. Clin. Oncol. 2017; 35: 1411-1420
- Early detection of ovarian cancer using the risk of ovarian cancer algorithm with frequent CA125 testing in women at increased familial risk - combined results from two screening trials.Clin. Cancer Res. 2017; 23: 3628-3637
- Can advanced-stage ovarian cancer be cured?.Nat. Rev. Clin. Oncol. 2016; 13: 255-261
- The impacts of neoadjuvant chemotherapy and of debulking surgery on survival from advanced ovarian cancer.Gynecol. Oncol. 2014; 134: 462-467
Article info
Publication history
Published online: September 06, 2019
Accepted:
August 31,
2019
Received in revised form:
August 27,
2019
Received:
March 25,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
