Specialist oncological surgery for removal of the ovaries and fallopian tubes in BRCA1 and BRCA2 pathogenic variant carriers may reduce primary peritoneal cancer risk to very low levels

Risk‐reducing bilateral salpingo‐oophorectomy (RRBSO) is highly effective for the prevention of high‐grade serous ovarian cancer (HGSOC) in BRCA1/2 pathogenic variant carriers (PVCs), but does not completely eliminate future risk of primary peritoneal cancer (PPC). The requirement to completely remo...

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Bibliographic Details
Published in:International journal of cancer 2021-03, Vol.148 (5), p.1155-1163
Main Authors: Crosbie, Emma J., Flaum, Nicola, Harkness, Elaine F., Clayton, Richard D., Holland, Cathrine, Martin‐Hirsch, Pierre, Wood, Nick, Keating, Patrick, Woodward, Emma R., Lalloo, Fiona, Donnai, Paul, Edmondson, Richard J., Evans, D. Gareth
Format: Article
Language:English
Subjects:
BRCA1 protein
BRCA2 protein
Cancer
Cancer Genetics and Epigenetics
Fallopian tubes
Gastric cancer
Genetic screening
Medical research
Ovarian cancer
Ovariectomy
Peritoneal cancer
Peritoneum
Surgery
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Summary:Risk‐reducing bilateral salpingo‐oophorectomy (RRBSO) is highly effective for the prevention of high‐grade serous ovarian cancer (HGSOC) in BRCA1/2 pathogenic variant carriers (PVCs), but does not completely eliminate future risk of primary peritoneal cancer (PPC). The requirement to completely remove fallopian tubes at RRBSO and carefully exclude occult cancer/serous tubal intraepithelial carcinoma (STIC) lesions may not have been appreciated historically. We calculated rates of HGSOC and PPC in confirmed BRCA1/2 PVCs registered on the regional database in those who did (cases) and did not (controls) undergo RRBSO after genetic testing. Expected annual rates of ovarian/peritoneal cancer were 1% for BRCA1 ≥ 35 years and 0.5% for BRCA2 ≥ 45 years. Follow‐up before 35/45 years was “risk free” and lead time excluded RRBSO
ISSN:0020-7136
1097-0215
DOI:10.1002/ijc.33378