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01-11-2010 | Epidemiology

Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers

Authors: Susan M. Domchek, Tara M. Friebel, Judy E. Garber, Claudine Isaacs, Ellen Matloff, Rosalind Eeles, D. Gareth Evans, Wendy Rubinstein, Christian F. Singer, Stephen Rubin, Henry T. Lynch, Mary B. Daly, Jeffrey Weitzel, Patricia A. Ganz, Gabriella Pichert, Olufunmilayo I. Olopade, Gail Tomlinson, Nadine Tung, Joanne L. Blum, Fergus Couch, Timothy R. Rebbeck

Published in: Breast Cancer Research and Treatment | Issue 1/2010

Abstract

Risk-reducing salpingo-oophorectomy (RRSO) is widely used for cancer risk reduction in BRCA1 or BRCA2 (BRCA1/2) mutation carriers. Occult ovarian/fallopian tube cancers (OOC) detected at the time of RRSO have been reported in several studies with wide variability in reported prevalence. We estimated the prevalence of OOC in a prospective cohort of 647 BRCA1/2 mutation carriers from 18 centers (PROSE consortium) who underwent RRSO between 2001 and 2008. OOC was detected in 16 of 647 women (2.5%). The mean age at RRSO was 51.7 in those with OOC versus 46.6 in those without OOC (P = 0.017). Twelve of the 16 OOCs (75%) were diagnosed in women with BRCA1 mutations. Thirty-eight percent of women with OOC had stage 1 cancer versus none of the women in the PROSE database diagnosed with ovarian cancer outside of screening. Among 385 women (60%) in whom pathology reports were available for central review, 246 (64%) RRSOs were performed at participating PROSE centers while 139 (36%) were performed at local sites. Ovarian and fallopian tube tissues removed at major genetics referral centers were significantly more likely to have been examined in toto compared to specimens obtained at non-referral centers (75% vs. 30%, P < 0.001). Our results confirm that OOC may be found at the time of RRSO in BRCA1/2 mutation carriers and suggest that OOC are of a more favorable stage than cancers found outside RRSO. An unacceptably high proportion of pathologic examinations did not adequately examine ovaries and fallopian tubes obtained at RRSO.

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Title: Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers
Authors: Susan M. Domchek
Tara M. Friebel
Judy E. Garber
Claudine Isaacs
Ellen Matloff
Rosalind Eeles
D. Gareth Evans
Wendy Rubinstein
Christian F. Singer
Stephen Rubin
Henry T. Lynch
Mary B. Daly
Jeffrey Weitzel
Patricia A. Ganz
Gabriella Pichert
Olufunmilayo I. Olopade
Gail Tomlinson
Nadine Tung
Joanne L. Blum
Fergus Couch
Timothy R. Rebbeck
Publication date: 01-11-2010
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2010
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-010-0799-x

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