title: The lack of clinical value of peritoneal washing cytology in high risk patients undergoing risk-reducing salpingo-oophorectomy: a retrospective study and review.
abstract: BACKGROUND
  To assess the clinical value of peritoneal washing cytology (PWC) in women with BRCA1 or BRCA2 mutations and women from a family with hereditary breast and/or ovarian cancer (HBOC) undergoing risk-reducing salpingo-oophorectomy (RRSO) in detecting primary peritoneal cancer (PPC) or occult ovarian/fallopian tube cancer.
  
  
  METHODS
  A retrospective study of patients with known BRCA1 or BRCA2 mutation or HBOC who underwent RRSO at the Erasmus Medical Centre, Rotterdam, The Netherlands between January 2000-2014. Patients with an elevated risk of malignancy prior to the procedure were excluded from primary analysis (elevated CA-125, an ovarian mass, abdominal pain or another gynecological malignancy). A review of the literature was conducted.
  
  
  RESULTS
  Of the 471 patients who underwent RRSO, a total of 267 cytology samples were available for analysis. Four samples showed malignant cells, all four patients were diagnosed with ovarian and/or fallopian tube cancer at histologic examination. A fifth patient, of whom no cytology sample was obtained during RRSO, developed primary peritoneal cancer 80 months post RRSO.
  
  
  CONCLUSIONS
  This study failed to show that cytology is of value during RRSO in detecting primary peritoneal cancer, however 36% of patients with concomitant ovarian or fallopian tube cancer had positive cytology. Therefore, the routine sampling of peritoneal washings during RRSO is not found to be useful to detect subsequent PPC.
authors.affiliation: Bachelor of Medicine at the Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Blok
authors.affiliation: Gynecologic Oncologist at Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Roes
authors.affiliation: Pathologist at Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: G J L H
authors.initials: GJ
authors.lastname: van Leenders
authors.affiliation: Gynecologic Oncologist at Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands. h.vanbeekhuizen@erasmusmc.nl.|Department of Obstetrics and Gynecology, Erasmus Medical Centre Cancer Institute, DHD-420, PO box 5201, 3008 AE, Rotterdam, The Netherlands. h.vanbeekhuizen@erasmusmc.nl.
authors.forename: H J
authors.initials: HJ
authors.lastname: van Beekhuizen
mesh_terms: D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D003581:Cytodiagnosis / Q000379:methods*; D005185:Fallopian Tube Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D010537:Peritoneum / Q000473:pathology; D011237:Predictive Value of Tests; D018570:Risk Assessment; D058994:Salpingectomy
chemical_list: D019313:BRCA1 Protein; D024682:BRCA2 Protein; C551750:BRCA2 protein, human