Pathologic findings at risk-reducing salpingo-oophorectomy among women at increased ovarian cancer risk: Results from GOG-199.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1519-1519 ◽  
Author(s):  
Phuong L. Mai ◽  
Mark E Sherman ◽  
Marion Piedmonte ◽  
Olga B. Ioffe ◽  
Brigitte M. Ronnett ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Family History ◽  
Brca Mutation ◽  
Brca2 Mutation ◽  
Ovarian Cancer Risk ◽  
Strong Family History ◽  
Mutation Carriers ◽  
Pelvic Cancer ◽  
Brca Mutation Carriers ◽  
Risk Reducing

1519 Background: Although risk-reducing salpingo-oophorectomy (RRSO) is a standard management option for women with BRCA1/2 mutations, the lack of large, prospective cohort studies makes estimating the prevalence of cancer at RRSO problematic. Methods: GOG-199 is a large, non-randomized multi-center trial which enrolled women at high-risk (due to BRCA mutations or strong family history) of ovarian cancer, comparing surgery at enrollment with serial transvaginal ultrasound and CA-125 screening. RRSO specimens were processed according to a standardized tissue processing protocol including 2-3mm sectioning of both ovaries and tubes. Results: 2,605 participants were accrued to GOG-199. Of the 1 030 enrolled in the baseline RRSO cohort, 28 were ineligible and 36 declined surgery after enrollment, resulting in 966 baseline RRSO. Pathology review demonstrated 4 tubal intraepithelial carcinoma and 20 serous pelvic cancers, of which 12 were identified only microscopically. Among the 20 serous cancers, the predominant or exclusive site of involvement was ovary in 10, fallopian tube in 5, and peritoneum in 5 cases. In addition, 6 endometrial cancers (among the 515 undergoing concomitant hysterectomy) and 3 adenocarcinomas suggestive of metastasis were identified. The serous pelvic cancer prevalence was: entire cohort=2.1% (20/966), all BRCA mutation carriers=3.2 (18/558), BRCA1 mutation carriers=3.7% (12/325), BRCA2 mutation carriers=2.6% (6/231), and mutation-negative=0.5% (2/402). Compared to those without cancer, women with serous pelvic cancer were older at surgery (p< .001), and more often menopausal (vs pre-menopausal, p= .002), nulliparous (vs parous, p=.04) and never users of tamoxifen (vs ever users, p= .04). Serous pelvic cancers were more frequent in BRCA mutation carriers (vs no mutation, p= .004), and among carriers, more common in those with BRCA1 mutations (vs BRCA2 mutation, p= .02). Conclusions: The prevalence of serous pelvic cancers in this cohort was 3.2% among carriers vs 0.5% among the mutation-negative but with a strong family history. Our data will be useful when counseling women at increased ovarian cancer risk who are contemplating risk-reducing surgery.

scholarly journals Cost Effectiveness of Risk-Reducing Mastectomy versus Surveillance in BRCA Mutation Carriers with a History of Ovarian Cancer

2017 ◽  
Vol 24 (11) ◽  
pp. 3116-3123 ◽  
Author(s):  
Charlotte Gamble ◽  
Laura J. Havrilesky ◽  
Evan R. Myers ◽  
Junzo P. Chino ◽  
Scott Hollenbeck ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Brca Mutation ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
History Of ◽  
Risk Reducing

Comparison of risk-reducing surgery in women with BRCA and non-BRCA ovarian cancer susceptibility genes.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1547-1547
Author(s):  
Zachary Phillip Schwartz ◽  
Mae Zakhour ◽  
Andrew John Li ◽  
Christine S. Walsh ◽  
Bj Rimel ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Susceptibility ◽  
Brca Mutation ◽  
Susceptibility Genes ◽  
Brca Mutations ◽  
Cancer Susceptibility Genes ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
History Of ◽  
Risk Reducing

1547 Background: Risk reducing gynecologic surgery (RRSO) is standard of care for women with BRCA mutations. The optimal management for women with non-BRCA ovarian cancer susceptibility mutations remains unclear. We sought to characterize the practice patterns for these women at our two institutions. Methods: Women with germline ovarian cancer susceptibility genes who had a RRSO were identified from 1/2000-1/2019 in an IRB approved study. All patients were asymptomatic with no suspicion for malignancy at time of RRSO. Clinico-pathologic characteristics were extracted from the medical records. Continuous variables were analyzed with Kruskal-Wallis and categorical variables analyzed with chi square and t-tests. Results: 152 BRCA1, 95 BRCA2, and 63 Non-BRCA mutation carriers were identified—50 Lynch (22 MLH1, 13 MSH2, 13 MSH6, 2 PMS2) and 13 Other (6 BRIP1, 2 RAD51C, 5 RAD51D). There was no difference between age at testing, age at RRSO, and interval between testing and RRSO between groups. Genetic counseling was higher in Non-BRCA patients. Family history of ovarian cancer was more common in women with BRCA1 and Other germline mutations compared to BRCA2 and Lynch. Family and personal history of breast cancer was high in all groups except Lynch carriers. Prophylactic mastectomy was seen mostly in BRCA mutation carriers. Concomitant hysterectomy was performed in the majority of women (BRCA1 59%, BRCA2 57%, and Other 62%), with the highest frequency in Lynch carriers (86%, p<.01). Occult cancer was only seen in BRCA mutation carriers: BRCA1 (7%), BRCA2 (2%), Lynch (0%), Other (0%). Conclusions: In this cohort, women with Non-BRCA mutations are managed similarly to women with BRCA mutations. We observed no occult cancers in Non-BRCA patients. The optimal role of surgery as a risk reducing strategy in this group requires further study. [Table: see text]

Risk-reducing salpingo-oophorectomy and breast cancer incidence among BRCA-mutation carriers.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10548-10548
Author(s):  
Tamar Perri ◽  
Shani Naor-Ravel ◽  
Perry Eliassi-Revivo ◽  
Dror Lifshitz ◽  
Eitan Friedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Brca Mutation ◽  
Brca2 Mutation ◽  
Breast Cancer Incidence ◽  
Mutation Carriers ◽  
Age At Surgery ◽  
Significant Difference ◽  
Brca Mutation Carriers ◽  
Risk Reducing

10548 Background: Uncertainty exists with regard to the role of bilateral salpingo-oophorectomy in altering the risk of breast cancer in BRCA-mutation carriers. Methods: Included were 1645 healthy Jewish Israeli BRCA1/2 -mutation carriers from a single center without prophylactic mastectomy. Carriers with and without risk-reducing bilateral salpingo-oophorectomy (RRBSO) were matched according to BRCA-mutation type (BRCA1 vs. BRCA2) and year of birth (±1 year). Hormonal and reproductive variables were compared and incidence of breast cancer recorded. Association between RRBSO and breast cancer was studied. Results: Seventy-seven and 50 matched-pairs had BRCA1 and BRCA2 mutation respectively. Fifty-two carriers had breast cancer, 21 in RRBSO-group and 31 in no- RRBSO group, with no statistically significant difference. When analysing each mutation group separately, stratified by age at surgery, no association between RRBSO and breast cancer incidence was found among BRCA1-mutation carriers. However, in BRCA2 mutation carriers, RRBSO was associated with a statistically significant decreased overall incidence of breast cancer, HR = 0.2 (confidence interval 0.44-0.913, p = 0.038). Breast cancer incidence was lower after 5, 10,15 and 20 years in BRCA2-mutation carriers with RRBSO compared to no-RRBSO. Age at menarche, age at surgery, parity and oral contraceptive use were not significant risk factors for breast cancer. Hormone replacement therapy was used by 62 mutation carriers, 52 in the RRBSO group and 10 in the no-RRBSO group, and its use did not alter breast cancer risk (p = 0.463). Conclusions: According to our findings, RRBSO is associated with a reduced risk of breast cancer only in BRCA2 mutation carriers, regardless of HRT use.

Breast & ovarian cancer risk in BRCA mutation carriers: Implications for prevention

1997 ◽  
Vol 33 ◽  
pp. S12-S13
Author(s):  
R. Catane ◽  
D. Halle ◽  
B. Kaufman ◽  
S. Eisenberg ◽  
R. Isaacson ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Risk ◽  
Brca Mutation ◽  
Ovarian Cancer Risk ◽  
Mutation Carriers ◽  
Brca Mutation Carriers

Association of personal and family history with decision to undergo risk-reducing salpingo-oophorectomy in BRCA mutation carriers

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 9560-9560
Author(s):  
N. D. Kauff ◽  
E. Wadsworth ◽  
D. J. Goldfrank ◽  
M. E. Robson ◽  
J. Lee ◽  
...  
Keyword(s):  
Family History ◽  
Brca Mutation ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
Risk Reducing

Genetic risk factors for familial ovarian cancer

2002 ◽  
Vol 8 (3) ◽  
pp. 92-97
Author(s):  
Elmar Stickeler ◽  
Ingo B Runnebaum
Keyword(s):  
Ovarian Cancer ◽  
Family History ◽  
Cancer Risk ◽  
Brca2 Mutation ◽  
Individual Risk ◽  
Ovarian Cancer Risk ◽  
Cancer Syndrome ◽  
Brca1 And Brca2 ◽  
Ovarian Cancers ◽  
Mutation Carriers

In Europe ovarian cancer represents the third most common cancer of the female genital tract, with 30,000 newly diagnosed patients per year. Family history is the most significant risk factor. Lifetime risk for ovarian cancer increases from 1.4% for women with a negative family history to 14.6-32.2% in women from affected families. About 5-10% of ovarian cancers are hereditary and supposed to occur in three different forms: hereditary breast and ovarian cancer syndrome (HBOC), site-specific hereditary ovarian cancer (HOC) and hereditary nonpolyposis colorectal cancer syndrome (HNPCC). HBOC and HOC account for 80-90% of the cases and are associated with inactivating germline mutations of the BRCA1 and BRCA2 genes. For BRCA1 and BRCA2 mutation carriers the cumulative risk by age 70 of developing ovarian cancer is 45-60% and 25-30%, respectively. Approximately 10-15% of familial ovarian cancers are related to the HNPCC syndrome with a cumulative ovarian cancer risk of 9% by age 70. Germline polymorphisms may further modify ovarian cancer risk. Bilateral prophylactic oophorectomy reduces the risk of developing ovarian cancer in HBOC and HOC families by 50%. Tubal ligation also significantly reduces the risk in BRCA1 mutation carriers (odds ratio 0.39). Knowledge of the genetic background provides an objective basis for individual risk assessment and prevention.

Impact of family history on choosing risk-reducing surgery among BRCA mutation carriers

2013 ◽  
Vol 208 (4) ◽  
pp. 329.e1-329.e6 ◽  
Author(s):  
Krishna Singh ◽  
Jenny Lester ◽  
Beth Karlan ◽  
Catherine Bresee ◽  
Tali Geva ◽  
...  
Keyword(s):  
Family History ◽  
Brca Mutation ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
Risk Reducing

The Effects of Parity, Breastfeeding, and Infertility Treatment on the Risk of Hereditary Breast and Ovarian Cancer: A Review

2010 ◽  
Vol 20 (Suppl 2) ◽  
pp. S31-S33 ◽  
Author(s):  
Ami Fishman
Keyword(s):  
Ovarian Cancer ◽  
Brca Mutation ◽  
Brca2 Mutation ◽  
Infertility Treatment ◽  
Accurate Information ◽  
Ovarian Cancer Risk ◽  
Breast And Ovarian Cancer ◽  
Brca1 And Brca2 ◽  
Mutation Carriers ◽  
Risk Of Cancer

Knowledge of the potential association of parity, breastfeeding, and infertility treatment on breast and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers is important and should be a crucial part of genetic counseling. The discussion of parity and clinical management of infertility in these women is complex, and patient preferences should be considered. Ideally, these preferences should be informed by accurate information on the risks and benefits of the interventions considered. However, this important subject has been investigated in a relatively small number of studies, thus, the existing data remain somewhat limited, and the estimated risk of cancer in BRCA mutation carriers is imprecise.

Tubal ligation does not modify ovarian cancer risk in BRCA mutation carriers

2015 ◽  
Vol 104 (3) ◽  
pp. e259 ◽  
Author(s):  
J. Chan ◽  
M.D. Sammel ◽  
T.M. Friebel ◽  
C. Gracia ◽  
T.R. Rebbeck
Keyword(s):  
Ovarian Cancer ◽  
Cancer Risk ◽  
Brca Mutation ◽  
Tubal Ligation ◽  
Ovarian Cancer Risk ◽  
Mutation Carriers ◽  
Brca Mutation Carriers
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