title: Effectiveness of risk-reducing salpingo-oophorectomy in preventing ovarian cancer in a high-risk French Canadian population.
abstract: BACKGROUND
  Women with germ line BRCA1 or BRCA2 mutations have a marked increased risk of breast and ovarian cancer compared with the general population, whereas risk-reducing salpingo-oophorectomy (RRSO) significantly lowers the incidence of these cancers. The objective of this study was to review the clinical and pathological characteristics of a French Canadian population undergoing RRSO. Surgical morbidity was also evaluated.
  
  
  METHODS
  From December 1999 to December 2009, all women who underwent RRSO at our institution were identified. Medical records were retrospectively reviewed. Descriptive statistics, the Fischer exact test, and the Student t test were used for analysis.
  
  
  RESULTS
  During the study period, RRSO was performed on 119 women. Mean age at surgery was 49 years (35-72 years), and 63 patients (53%) were premenopausal. Sixty-two women (52%) had a history of in situ or invasive breast cancer. BRCA1 and BRCA2 mutations were present in 34 patients (29%) and 42 patients (35%), respectively, whereas 43 patients (36%) were considered to have an increased risk of breast and ovarian cancer, despite a personal genetic test, which was either negative (n = 23) or unknown because the patient declined genetic testing (n = 20). Most patients with a uterus in place had a complementary hysterectomy (65%). Six complications occurred (3 hematomas, 2 cardiac arrhythmias, and 1 cystotomy). In one patient (0.8%), a high-grade stage II ovarian cancer was discovered at the time of surgery. Fallopian tube atypias were identified on final pathology in 8 cases (6.7%). After a median follow-up of 22 months, 4 women (3.4%) developed breast cancer and one woman (0.8%) developed peritoneal cancer.
  
  
  CONCLUSIONS
  Risk-reducing salpingo-oophorectomy is highly effective in preventing ovarian, fallopian tube, and breast cancers in a high-risk French Canadian population; and the surgical morbidity is low.
authors: Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. omarmbacha@terra.com.br
authors: Omar Moreira
authors: OM
authors: Bacha
authors: Jean
authors: J
authors: Gregoire
authors: Katherine
authors: K
authors: Grondin
authors: Maria Isabel
authors: MI
authors: Edelweiss
authors: Rachel
authors: R
authors: Laframboise
authors: Jacques
authors: J
authors: Simard
authors: Marie
authors: M
authors: Plante
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000208:ethnology / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy / Q000706:statistics & numerical data*; D010053:Ovary / Q000473:pathology; D012189:Retrospective Studies; D058994:Salpingectomy / Q000706:statistics & numerical data*