@article{2f0e0a8f4cfb4a43953d2f6e207612d0,
title = "Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers",
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.",
keywords = "BRCA1, BRCA2, Hereditary ovarian cancer, Prophylactic Surgery",
author = "Domchek, {Susan M.} and Friebel, {Tara M.} and Garber, {Judy E.} and Claudine Isaacs and Ellen Matloff and Rosalind Eeles and Evans, {D. Gareth} and Wendy Rubinstein and Singer, {Christian F.} and Stephen Rubin and Lynch, {Henry T.} and Daly, {Mary B.} and Jeffrey Weitzel and Ganz, {Patricia A.} and Gabriella Pichert and Olopade, {Olufunmilayo I.} and Gail Tomlinson and Nadine Tung and Blum, {Joanne L.} and Fergus Couch and Rebbeck, {Timothy R.}",
note = "Funding Information: Acknowledgments All participants provided written informed consent for participation in this study using protocols approved by the Institutional Review Boards of each contributing institution. In addition, the University of Pennsylvania Institutional Review Board approved the overall data collection and analysis protocol for the collaborative data. This study was supported by grants from the Public Health Service (R01-CA83855 and R01-CA102776 to TRR; CA74415 to SLN), the University of Pennsylvania Cancer Center (to TRR), the Cancer Genetics Network (to SMD and CI) the Dana-Farber Women{\textquoteright}s Cancers Program (to JEG), the Department of Defense (DAMD-17-96-I-6088 to AKG; DAMD-17-94-J-4340 and DAMD-17-97-I-7112 to HTL; DAMD-17-03-1-0619 to SMD), The Utah Cancer registry (funded by Public Health Service Grant NO1-CN-6700), the Utah State Department of Health,), the National Cancer Institute (2 P30 CA51008-15 to CI) and the Nebraska State Cancer and Smoking-Related Diseases Research Program (LB595 to HTL). DGE is supported by the NIHR Biomedical Research centre at Central Manchester Foundation Trust. OIO is Doris Duke Distinguished Clinical Scientist. None of these funding agencies had involvement in the study design; collection, analysis, or interpretation of data; in the writing of the report; nor in the decision to submit the paper for publication.",
year = "2010",
month = nov,
doi = "10.1007/s10549-010-0799-x",
language = "English (US)",
volume = "124",
pages = "195--203",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "1",
}