Prophylactic bilateral salpingo-oophorectomy compared with surveillance in women with BRCA mutations.
OBJECTIVE
The objective of this study was to evaluate clinical factors associated with choosing prophylactic bilateral salpingo-oophorectomy (BSO) over surveillance in women with a BRCA1 or BRCA2 mutation.


METHODS
Between 1996 and 2005, 139 women who tested positive for a BRCA1 or BRCA2 mutation were identified. Thirty-three women were excluded due to a personal history of ovarian or fallopian tube cancer before genetic testing, resulting in 106 women for the final analysis. The characteristics of women who underwent prophylactic BSO were compared with those choosing surveillance.


RESULTS
Sixty-five of the BRCA mutation carriers (61%) underwent prophylactic BSO. Median age at BSO was 45.6 years. Median time from disclosure of genetic test results to surgery was 4.6 months. Eighty-five percent of women who underwent prophylactic BSO were parous compared with 66% of women who chose surveillance (P = .03). A previous diagnosis of breast cancer was noted in 72% of women who underwent prophylactic BSO compared with 46% of women undergoing surveillance (P < .01). Fifty-two women (80%) had hysterectomy performed at the time of BSO. Two women had incidental ovarian cancer diagnosed at time of surgery.


CONCLUSIONS
Age greater than 40 years, parity, and a personal history of breast cancer were associated with choosing prophylactic BSO in our cohort. A short time interval was noted from the time of receiving positive genetic test results to undergoing prophylactic surgery.
Schmeler
Kathleen M
KM
Department of Gynecologic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas 77230, USA.
Sun
Charlotte C
CC
Bodurka
Diane C
DC
White
Kristin G
KG
Soliman
Pamela T
PT
Uyei
Anne R
AR
Erlichman
Julie L
JL
Arun
Banu K
BK
Daniels
Molly S
MS
Rimes
Susan A
SA
Peterson
Susan K
SK
Slomovitz
Brian M
BM
Milam
Michael R
MR
Gershenson
David M
DM
Lu
Karen H
KH
D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005185:Fallopian Tube Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D007044:Hysterectomy; D008408:Mastectomy; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000601:surgery; D010052:Ovariectomy; D010298:Parity; D011247:Pregnancy; D012489:Salpingostomy / Q000379:methods*; D013997:Time Factors