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

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 CouchTimothy R. Rebbeck

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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.

Original languageEnglish
Pages (from-to)195-203
Number of pages9
JournalBreast Cancer Research and Treatment
Volume124
Issue number1
DOIs
StatePublished - Nov 2010

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Fallopian Tube Neoplasms
Ovariectomy
Ovarian Neoplasms
Mutation
Fallopian Tubes
Neoplasms
Risk Reduction Behavior
Early Detection of Cancer
Ovary
Referral and Consultation
Databases
Pathology

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers. / Domchek, Susan M.; Friebel, Tara M.; Garber, Judy E.; Isaacs, Claudine; Matloff, Ellen; Eeles, Rosalind; Evans, D. Gareth; Rubinstein, Wendy; Singer, Christian F.; Rubin, Stephen; Lynch, Henry T.; Daly, Mary B.; Weitzel, Jeffrey; Ganz, Patricia A.; Pichert, Gabriella; Olopade, Olufunmilayo I.; Tomlinson, Gail; Tung, Nadine; Blum, Joanne L.; Couch, Fergus; Rebbeck, Timothy R.

In: Breast Cancer Research and Treatment, Vol. 124, No. 1, 11.2010, p. 195-203.

Research output: Contribution to journalArticle

Domchek, SM, Friebel, TM, Garber, JE, Isaacs, C, Matloff, E, Eeles, R, Evans, DG, Rubinstein, W, Singer, CF, Rubin, S, Lynch, HT, Daly, MB, Weitzel, J, Ganz, PA, Pichert, G, Olopade, OI, Tomlinson, G, Tung, N, Blum, JL, Couch, F & Rebbeck, TR 2010, 'Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers', Breast Cancer Research and Treatment, vol. 124, no. 1, pp. 195-203. https://doi.org/10.1007/s10549-010-0799-x
Domchek, Susan M. ; Friebel, Tara M. ; Garber, Judy E. ; Isaacs, Claudine ; Matloff, Ellen ; Eeles, Rosalind ; Evans, D. Gareth ; Rubinstein, Wendy ; Singer, Christian F. ; Rubin, Stephen ; Lynch, Henry T. ; Daly, Mary B. ; Weitzel, Jeffrey ; Ganz, Patricia A. ; Pichert, Gabriella ; Olopade, Olufunmilayo I. ; Tomlinson, Gail ; Tung, Nadine ; Blum, Joanne L. ; Couch, Fergus ; Rebbeck, Timothy R. / Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers. In: Breast Cancer Research and Treatment. 2010 ; Vol. 124, No. 1. pp. 195-203.
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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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AU - Garber, Judy E.

AU - Isaacs, Claudine

AU - Matloff, Ellen

AU - Eeles, Rosalind

AU - Evans, D. Gareth

AU - Rubinstein, Wendy

AU - Singer, Christian F.

AU - Rubin, Stephen

AU - Lynch, Henry T.

AU - Daly, Mary B.

AU - Weitzel, Jeffrey

AU - Ganz, Patricia A.

AU - Pichert, Gabriella

AU - Olopade, Olufunmilayo I.

AU - Tomlinson, Gail

AU - Tung, Nadine

AU - Blum, Joanne L.

AU - Couch, Fergus

AU - Rebbeck, Timothy R.

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N2 - 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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