OBJECTIVE: To compare surgical outcomes and occult cancer rates at risk-reducing salpingo-oophorectomy in BRCA carriers and high-risk women who had not undergone genetic testing. DESIGN: Prospective cohort study. SETTING: Tertiary high-risk familial gynaecological cancer clinic. POPULATION: Women undergoing risk-reducing salpingo-oophorectomy between January 2005 and November 2009. METHODS: Women at high-risk of ovarian/tubal cancer were identified on the basis of the inclusion criteria for the UK Familial Ovarian Cancer Screening Study. Risk management options discussed with 1456 high-risk women included risk-reducing salpingo-oophorectomy. A strict histopathological protocol with serial slicing was used to assess tubes and ovaries. RESULTS: In total, 308 high-risk women (191 with unknown mutation status; 117 known BRCA1/BRCA2 carriers) chose risk-reducing surgery; 94.5% of procedures were performed laparoscopically. The surgical complication rate was 3.9% (95% CI 2.0-6.7). Four ovarian and ten tubal occult invasive/in situ cancers were found. The overall occult invasive cancer rate was 5.1% (95% CI 1.9-10.83) in BRCA1/BRCA2 carriers and 1.05% (95% CI 0.13-3.73) in untested women. When tubal in situ cancers were included, the overall rate was 4.55% (95% CI 2.5-7.5). Two untested women with tubal carcinoma in situ were subsequently found to be BRCA carriers. The median ages of BRCA carriers (58 years; IQR 13.4 years) and untested women (49.5 years; IQR 20.6 years) with occult invasive/in situ cancer were not significantly different (P = 0.454). CONCLUSIONS: Both high-risk women of unknown mutation status and BRCA carriers have a significant (although higher in the latter group) rate of occult invasive/in situ tubal/ovarian cancer, with a similar age distribution at detection. The data has important implications for counselling high-risk women on the likelihood of occult malignancy and perioperative complications at risk-reducing salpingo-oophorectomy. Women with occult disease should be offered genetic testing.
OBJECTIVE: To compare surgical outcomes and occult cancer rates at risk-reducing salpingo-oophorectomy in BRCA carriers and high-risk women who had not undergone genetic testing. DESIGN: Prospective cohort study. SETTING: Tertiary high-risk familial gynaecological cancer clinic. POPULATION: Women undergoing risk-reducing salpingo-oophorectomy between January 2005 and November 2009. METHODS:Women at high-risk of ovarian/tubal cancer were identified on the basis of the inclusion criteria for the UK Familial Ovarian Cancer Screening Study. Risk management options discussed with 1456 high-risk women included risk-reducing salpingo-oophorectomy. A strict histopathological protocol with serial slicing was used to assess tubes and ovaries. RESULTS: In total, 308 high-risk women (191 with unknown mutation status; 117 known BRCA1/BRCA2 carriers) chose risk-reducing surgery; 94.5% of procedures were performed laparoscopically. The surgical complication rate was 3.9% (95% CI 2.0-6.7). Four ovarian and ten tubal occult invasive/in situ cancers were found. The overall occult invasive cancer rate was 5.1% (95% CI 1.9-10.83) in BRCA1/BRCA2 carriers and 1.05% (95% CI 0.13-3.73) in untested women. When tubal in situ cancers were included, the overall rate was 4.55% (95% CI 2.5-7.5). Two untested women with tubal carcinoma in situ were subsequently found to be BRCA carriers. The median ages of BRCA carriers (58 years; IQR 13.4 years) and untested women (49.5 years; IQR 20.6 years) with occult invasive/in situ cancer were not significantly different (P = 0.454). CONCLUSIONS: Both high-risk women of unknown mutation status and BRCA carriers have a significant (although higher in the latter group) rate of occult invasive/in situ tubal/ovarian cancer, with a similar age distribution at detection. The data has important implications for counselling high-risk women on the likelihood of occult malignancy and perioperative complications at risk-reducing salpingo-oophorectomy. Women with occult disease should be offered genetic testing.
Authors: James R Conner; Emily Meserve; Ellen Pizer; Judy Garber; Michael Roh; Nicole Urban; Charles Drescher; Bradley J Quade; Michael Muto; Brooke E Howitt; Mark D Pearlman; Ross S Berkowitz; Neil Horowitz; Christopher P Crum; Colleen Feltmate Journal: Gynecol Oncol Date: 2013-12-12 Impact factor: 5.482
Authors: Stephanie L Wethington; Kay J Park; Robert A Soslow; Noah D Kauff; Carol L Brown; Fanny Dao; Ebunoluwa Otegbeye; Yukio Sonoda; Nadeem R Abu-Rustum; Richard R Barakat; Douglas A Levine; Ginger J Gardner Journal: Int J Gynecol Cancer Date: 2013-11 Impact factor: 3.437
Authors: C B Powell; E M Swisher; I Cass; J McLennan; B Norquist; R L Garcia; J Lester; B Y Karlan; L Chen Journal: Gynecol Oncol Date: 2013-02-04 Impact factor: 5.482
Authors: Michelle D Sakala; Nicole E Curci; William R Masch; Mishal Mendiratta-Lala; Erica B Stein; Ashish P Wasnik; Andrew P Sciallis; Shitanshu Uppal; Mark D Pearlman; Katherine E Maturen Journal: Radiol Imaging Cancer Date: 2020-11-13
Authors: Adam N Rosenthal; Lindsay Fraser; Ranjit Manchanda; Philip Badman; Susan Philpott; Jessica Mozersky; Richard Hadwin; Fay H Cafferty; Elizabeth Benjamin; Naveena Singh; D Gareth Evans; Diana M Eccles; Steven J Skates; James Mackay; Usha Menon; Ian J Jacobs Journal: J Clin Oncol Date: 2012-12-03 Impact factor: 44.544
Authors: Mark E Sherman; Marion Piedmonte; Phuong L Mai; Olga B Ioffe; Brigitte M Ronnett; Linda Van Le; Iouri Ivanov; Maria C Bell; Stephanie V Blank; Paul DiSilvestro; Chad A Hamilton; Krishnansu S Tewari; Katie Wakeley; Noah D Kauff; S Diane Yamada; Gustavo Rodriguez; Steven J Skates; David S Alberts; Joan L Walker; Lori Minasian; Karen Lu; Mark H Greene Journal: J Clin Oncol Date: 2014-09-08 Impact factor: 44.544