Prophylactic salpingo-oophorectomy in a series of 89 women carrying a BRCA1 or a BRCA2 mutation.
BACKGROUND
Prophylactic salpingo-oophorectomy (SO), which is recommended in BRCA1/2 mutation carriers, still needs to be reappraised.


METHODS
In all, 89 BRCA1/BRCA2 mutation carriers underwent SO between 1994-2004. Past medical and familial history, SO, results and survival after SO were analyzed.


RESULTS
The series consisted of 56 BRCA1 and 33 BRCA2 mutation carriers. All but 1 had a family history of breast (BC) and/or ovarian cancer; 42 BRCA1 and 31 BRCA2 had a personal history of BC. The median age at SO was 44 (BRCA1) and 49.5 (BRCA2) years for women without previous BC (not significant) and 48 (BRCA1) and 53 BRCA2) years (P=.03) for women with previous BC. Occult ovarian (n=2) and/or fallopian (n=3) carcinomas were found in 4 patients (4.5%): 1 experienced recurrence (4 years), 2 are disease-free (26 and 38 months of follow-up), and 1 died from BC (12 months). Among the other 69 patients with previous BC (median follow-up, 42 months), 14 developed ipsilateral or contralateral BC and 8 developed metastatic disease. Among the 16 patients without previous BC (median follow-up, 27 months), 3 developed BC. Of the 89 patients, 85 are still alive: 3 died from BC and 1 died from pancreatic cancer. No peritoneal malignancy was observed.


CONCLUSIONS
This study shows that prophylactic SO remains an important option for BRCA1/2 mutation carriers as asymptomatic ovarian/fallopian cancers were found in 4.5% of patients. However, a longer follow-up and larger series are required to more precisely evaluate the benefits of this procedure in terms of BC incidence, peritoneal malignancy, or recurrence.
Laki
Fatima
F
Department of Surgery, Institut Curie, Paris, France. fatima.laki@curie.net
Kirova
Youlia M
YM
This
Pascale
P
Plancher
Corinne
C
Asselain
Bernard
B
Sastre
Xavier
X
Stoppa-Lyonnet
Dominique
D
Salmon
Remy
R
D000328:Adult; D001943:Breast Neoplasms / Q000517:prevention & control; D005185:Fallopian Tube Neoplasms / Q000235:genetics / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000401:mortality / Q000517:prevention & control*; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000235:genetics / Q000517:prevention & control; D012189:Retrospective Studies