Abstract
Background
Due to ineffective ovarian cancer (OC) screening programs, prophylactic bilateral
salpingo-oophorectomy (PBSO) is suggested for BRCA1/2 genes mutation carriers. The reported incidence of clinically occult neoplasia and
OC detected during PBSO varies widely (2–17 %), reflecting differences in studies
design.
Objective
We aimed to prospectively evaluate the incidence of occult neoplasia in specimens
collected during PBSO performed in a single tertiary center and to determine the effectiveness
of this procedure in BRCA1/2 mutation carriers.
Study design
Between January 2010 and October 2016 a total of 564 new germline BRCA1/2 mutation positive women were identified and 71 carriers underwent laparoscopic PBSO.
Patients were prospectively followed-up after the surgery and data on operation, age,
complications, histological reports and BRCA1/2 gene mutation types were collected
and analyzed.
Results
Serous tubal intraepithelial carcinoma (STIC) was diagnosed in 7 (9.85 %) and OC in
4 (5.6 %) women (one advanced (FIGO IIIC) and 3 early (FIGO IA/C) stages); total incidence
15.5 %. Women's mean age at the time of surgery was 46.5 years. The mean age of women
diagnosed with STIC and OC was 45.9 years (42–64). The mean follow up time for women
being diagnosed with OC/STIC was 3.72 years; no recurrence was observed. The median
time to perform laparoscopic PBSO was 43 min. (ranging from 25 to 65 min.), no surgical
complications occurred during this operation. Interestingly, we found statistically
significant (P = 0.0105) enrichment of STIC lesions in BRCA1 c.4035delA (an established Baltic founder mutation) carriers group.
Conclusion
The incidence of pathological findings in BRCA1/2 mutation carries after PBSO is sufficiently high and our prospective study data supports
PBSO as the most effective measure for reducing the risk of OC in BRCA1/2 mutation carriers. A novel finding of the enrichment of STIC lesions in BRCA1 c.4035delA carriers may show important biological differences in OC tumorigenesis
between different BRCA1 mutations, which warrant further investigations.
Keywords
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Article info
Publication history
Published online: January 30, 2020
Accepted:
January 29,
2020
Received in revised form:
January 24,
2020
Received:
July 30,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
