[Familial history of ovarian carcinoma: policy].
Women who carry a BRCA mutation have a greatly increased risk for serous ovarian carcinoma and tubal carcinoma. Since preventative ovarian screening is not effective, these women are advised to undergo prophylactic bilateral salpingo-oophorectomy (pBSO) around the age of 40 years. Following pBSO, hormone replacement therapy is advisable up to the age of 45-50 years, with the exception of those women with a history of breast cancer. The advice for women with a familial history of ovarian carcinoma but without the BRCA mutation is less clear. Based on data from the literature, we suggest considering pBSO only in women with at least two first or second degree family members with epithelial ovarian carcinoma. pBSO is not indicated in women from families without a BRCA mutation who have no family members, or just one family member, with epithelial ovarian carcinoma. In these families the lifetime risk for ovarian cancer is considered to be well below 10%.
Universitair Medisch Centrum St Radboud, Afd. Obstetrie en Gynaecologie, Nijmegen, The Netherlands. j.dehullu@obgyn.umcn.nl
Joanne A
JA
de Hullu
C Marleen
CM
Kets
Leon F
LF
Massuger
Marjolijn L
ML
Ligtenberg
Maaike A
MA
van Ham
Nicoline
N
Hoogerbrugge
D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D006801:Humans; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D010052:Ovariectomy; D017410:Practice Guidelines as Topic