Pathologic findings at risk-reducing salpingo-oophorectomy in germline BRCA mutation carriers: Optimal age of bilateral RRSO.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13046-e13046
Author(s):  
Yong-Man Kim ◽  
Shin-Wha Lee ◽  
Young-jae Lee
Keyword(s):  
Medical Center ◽  
Metastatic Cancer ◽  
Brca Mutation ◽  
Brca1 Mutation ◽  
Premalignant Lesions ◽  
Mutation Carriers ◽  
Brca 1 ◽  
Brca Mutation Carriers ◽  
Germline Brca Mutation ◽  
Risk Reducing

e13046 Background: Most BRCA1/2 carriers do not undergo risk-reducing salpingo-oophorectomy (RRSO) by the recommended age of 40. Methods: We retrospectively reviewed breast cancer patients identified as BRCA mutation carriers who underwent RRSO at Asan Medical Center, Seoul, Korea, from 2013 to 2015. Both fallopian tubes of all cases were examined according to the SEE/FIM protocol and immunohistochemically (IHC) staining was performed when a precursor lesion was suspected. Results: RRSO was performed in 55 patients. The median age at RRSO was 44 years (32–73 years). Of the 36 patients with IHC staining, 7 showed p53 overexpression, 1 showed Ki-67 overexpression, 2 showed serous tubal intraepithelial carcinoma, 2 showed occult cancer, and 1 showed metastatic cancer of breast origin. All occult invasive cancer cases were tubal origin and detected in patients older than 40 years. The detection rate of premalignant lesions or cancer was 21.8% (12/55). Among patients who underwent RRSO under the age of 40, premalignant lesions were found only in BRCA 1 mutation carriers (40.0% vs 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. Conclusions: 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, especially in BRCA 1 mutation carriers.

scholarly journals Risk-Reducing Bilateral Salpingo-Oophorectomy for BRCA Mutation Carriers and Hormonal Replacement Therapy: If It Should Rain, Better a Drizzle than a Storm

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 415
Author(s):  
Maria Luisa Gasparri ◽  
Katayoun Taghavi ◽  
Enrico Fiacco ◽  
Veronica Zuber ◽  
Rosa Di Micco ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Replacement Therapy ◽  
Brca Mutation ◽  
Brca1 Mutation ◽  
Effective Strategy ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
Risk Reducing

Women carrying a BRCA mutation have an increased risk of developing breast and ovarian cancer. The most effective strategy to reduce this risk is the bilateral salpingo-oophorectomy, with or without additional risk-reducing mastectomy. Risk-reducing bilateral salpingo-oophorectomy (RRBSO) is recommended between age 35 and 40 and between age 40 and 45 years for women carriers of BRCA1 and BRCA2 mutations, respectively. Consequently, most BRCA mutation carriers undergo this procedure prior to a natural menopause and develop an anticipated lack of hormones. This condition has a detrimental impact on various systems, affecting both the quality of life and longevity; in particular, women carrying BRCA1 mutation, who are likely to have surgery earlier as compared to BRCA2. Hormonal replacement therapy (HRT) is the only effective strategy able to significantly compensate the hormonal deprivation and counteract menopausal symptoms, both in spontaneous and surgical menopause. Although recent evidence suggests that HRT does not diminish the protective effect of RRBSO in BRCA mutation carriers, concerns regarding the safety of estrogen and progesterone intake reduce the use in this setting. Furthermore, there is strong data demonstrating that the use of estrogen alone after RRBSO does not increase the risk of breast cancer among women with a BRCA1 mutation. The additional progesterone intake, mandatory for the protection of the endometrium during HRT, warrants further studies. However, when hysterectomy is performed at the time of RRBSO, the indication of progesterone addition decays and consequently its potential effect on breast cancer risk. Similarly, in patients conserving the uterus but undergoing risk-reducing mastectomy, the addition of progesterone should not raise significant concerns for breast cancer risk anymore. Therefore, BRCA mutation carriers require careful counselling about the scenarios following their RRBSO, menopausal symptoms or the fear associated with HRT use.

How to manage BRCA mutation carriers?

2020 ◽  
Vol 41 (3) ◽  
Author(s):  
Laura Sabiani ◽  
Julien Barrou ◽  
Jérome Mathis ◽  
Francois Eisinger ◽  
Marie Bannier ◽  
...  
Keyword(s):  
Brca Mutation ◽  
Brca1 Mutation ◽  
Brca2 Mutation ◽  
Immediate Breast Reconstruction ◽  
Bilateral Mastectomy ◽  
Brca1 And Brca2 ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
The Impact ◽  
Risk Reducing

AbstractInherited mutations in BRCA1 and BRCA2 genes increase the risk of development of cancer in organs especially in breast and ovary. Prevention and screening in BRCA mutation carriers are of high importance. Prophylactic surgeries are possible but are still insufficiently performed because they require surgical procedures in healthy patients. Guidelines for the management of BRCA mutations carriers must absolutely be part of the standard practice of all those involved in the management of these patients to increase the impact of the implementation of these preventive measures. There is no screening recommended for ovarian cancer. A risk-reducing bilateral salpingo-oophorectomy should be performed from age 35 to 40 years for BRCA1 mutation carriers and 40 to 45 years for BRCA2 mutation carriers. A screening for breast cancer should be performed annually from 30 years old by breast MRI and mammography. A risk-reducing bilateral mastectomy is recommended with nipple sparing mastectomy and immediate breast reconstruction from 30 years and before 40 years. A multidisciplinary care must be implemented for these patients with an important psychological support.

Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing

2010 ◽  
Vol 77 (4) ◽  
pp. 342-349 ◽  
Author(s):  
A-B Skytte ◽  
A-M Gerdes ◽  
MK Andersen ◽  
L Sunde ◽  
K Brøndum-Nielsen ◽  
...  
Keyword(s):  
Brca Mutation ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
Risk Reducing

Endometrial Cancer in Germline BRCA Mutation Carriers: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Emad Matanes ◽  
Alexander Volodarsky-Perel ◽  
Neta Eisenberg ◽  
Misgav Rottenstreich ◽  
Amber Yasmeen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endometrial Cancer ◽  
Brca Mutation ◽  
Meta Analysis ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
Germline Brca Mutation
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