title: [Characteristics of selected clinical features in BRCA1 mutation carriers affected with breast cancer undergoing preventive female genital tract surgeries].
abstract: OBJECTIVE
  Evaluation of patient age and time of the prophylactic surgery as well as incidence of genital cancers and precancerous states observed in histopathology of the postoperative material from BRCA1 gene mutation carriers previously treated for breast cancer.
  
  
  METHODS
  206 carriers of one of the three most common BRCA1 gene mutations (5382insC, C61G and 4153delA) in the Polish population, who were offered the option of prophylactic salpingo-oophorectomy The study group comprised 85 patients with the diagnosis of breast cancer before gynecological preventive surgery The study group was further divided into two subgroups for more detailed assessment of the tested variables. The first subgroup included 67 patients with breast cancer (unilateral or bilateral synchronous). The second subgroup included 18 patients with bilateral metachronous (the second diagnosis of breast cancer was at least 12 months after the first breast cancer diagnosis). The control group consisted of 121 patients with no cancerous lesions before preventive gynecologic surgery The patients undergoing prophylactic treatment had no prior symptoms in female sexual organ and no changes in the diagnostic tests.
  
  
  RESULTS
  The patients with a history of breast cancer underwent genetic testing and preventive surgery of the genital tract at a significantly later age than controls (respectively p = 0.0003, p = 0.0006). The patients with bilateral metachronous breast cancer underwent preventive surgery significantly earlier (p = 0.03). There was a trend indicating a 2.5 times higher risk of developing ovarian cancer among BRCA1 mutation carriers who had already been diagnosed and treated for breast cancer when compared to women without breast cancer diagnosis. The incidence of other genital cancers and precancerous states in BRCA1 gene mutation carriers with history of breast cancer was not statistically significant as compared to controls. Data on the clinical stage, morphological grade, histological type, age and type of pathology and the type of BRCA1 gene mutation did not show a statistically significant difference between the groups.
  
  
  CONCLUSIONS
  Each patient diagnosed with breast cancer should be strongly recommended a genetic test to reduce adverse consequences resulting from postponing the test and, if applicable, the preventive operation until later in life. Preventive surgery should be considered especially in BRCA1 gene mutation carriers previously treated for breast cancer because of the increased risk of ovarian cancer
authors.affiliation: Katedra i Klinika Ginekologii Operacyjnej i Onkologii Ginekologicznej Dorosłych i Dziewczat PUM w Szczecinie, Polska. nbz@list.pl
authors.forename: Janusz
authors.initials: J
authors.lastname: Menkiszak
authors.forename: Anita
authors.initials: A
authors.lastname: Chudecka-Głaz
authors.forename: Jacek
authors.initials: J
authors.lastname: Gronwald
authors.forename: Ryszard
authors.initials: R
authors.lastname: Bedner
authors.forename: Aneta
authors.initials: A
authors.lastname: Cymbaluk-Płoska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wezowska
authors.forename: Dorota
authors.initials: D
authors.lastname: Zielińska
authors.forename: Izabella
authors.initials: I
authors.lastname: Rzepka-Górska
mesh_terms: D000328:Adult; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D061325:Hereditary Breast and Ovarian Cancer Syndrome / Q000235:genetics* / Q000517:prevention & control / Q000601:surgery*; D006579:Heterozygote; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000601:surgery; D010052:Ovariectomy; D040242:Risk Reduction Behavior; D058994:Salpingectomy
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human