Risk-reducing salpingo-oophorectomy in BRCA1 and BRCA2 mutation carriers.
BACKGROUND
Risk-reducing salpingo-oophorectomy (RRSO) is often recommended to carriers of deleterious breast cancer gene 1/2 (BRCA1/2) mutations in order to reduce their breast cancer risk by 50% and their ovarian cancer risk by approximately 95%. To evaluate the acceptance, timing, histopathology findings and follow-up results we retrospectively analyzed a cohort of BRCA1/2 mutation carriers who underwent risk-reducing salpingo-oophorectomies.


METHODS
Between 1996 and 2009, 306 women who tested positive for a BRCA1 or BRCA2 mutation were counseled for preventive options. RRSO was recommended to all mutation carriers at age 40 or 5 years prior to the earliest occurrence of ovarian cancer in the family. Data from 175 BRCA mutation carriers (92 BRCA1 and 83 BRCA2), who decided to undergo a RRSO, were analyzed. Data were collected from study entry until recent follow-up.


RESULTS
Fifty-seven percent of BRCA mutation carriers opted for RRSO. Mean age at time of surgery was 47 years. Overall, one occult carcinoma of the fallopian tube was detected at the time of surgery in a 57-year-old woman and one primary peritoneal carcinoma occurred 26 months after RRSO in a 59-year-old woman.


CONCLUSIONS
Risk-reducing salpingo-oophorectomy is widely accepted. Recommendation of surgery at the age of 40 seems to be safe and the frequency of extraovarian primary peritoneal carcinoma after surgery is low.
Rhiem
Kerstin
K
Center for Familial Breast and Ovarian Cancer, Department of Obstetrics and Gynecology, University of Cologne School of Medicine, Kerpener Str. 62, 50937 Cologne, Germany.
Foth
Dolores
D
Wappenschmidt
Barbara
B
Gevensleben
Heidrun
H
Büttner
Reinhard
R
Ulrich
Uwe
U
Schmutzler
Rita K
RK
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D002277:Carcinoma / Q000235:genetics / Q000517:prevention & control*; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis / Q000601:surgery; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000175:diagnosis; D012189:Retrospective Studies; D012306:Risk; D058994:Salpingectomy