title: Clinical and Pathological Characteristics of Incidental Diagnostic Early Occult Malignancy After Risk-Reducing Salpingo-Oophorectomy in BRCA Mutation Carriers.
abstract: OBJECTIVE
  Carriers of familial BRCA mutations are at high risk of early development of ovarian tubal or peritoneal cancers. The definite preventative treatment for these cases is early, risk-reducing, bilateral salpingo-oophorectomy (BSO). The aims of the study were to describe the incidence and source of early occult malignancy after risk-reducing salpingo-oophorectomy in carriers of Ashkenazi Jewish BRCA mutations and to characterize the clinical and pathological features of this unique population.
  
  
  METHODS
  Data were collected retrospectively regarding women who underwent BSO in our gynecologic oncology unit from January 2002 through July 2012, after a positive test for a BRCA1 or BRCA2 mutation.
  
  
  RESULTS
  The following 92 cases of BRCA mutations were included: 53 BRCA1, 37 BRCA2, and 2 with both mutations. After risk-reducing salpingo-oophorectomy, 5 (5.4%) of the patients were found to have early occult adnexal malignancy upon pathology study. All 5 had the BRCA1 185 del-AG mutation. Three of the 5 malignancies originated from the ovaries and 2 in the fallopian tubes with no involvement of the ovaries.
  
  
  CONCLUSIONS
  A 5.4% incidence of early occult malignancy in adnexal pathology of BSO was found in carriers of Ashkenazi Jewish BRCA mutations. Two cases with malignant origins within the fallopian tube, while sparing the ovaries in their entirety, support the fallopian tubes as the originating organ for some ovarian or peritoneal malignancies in BRCA mutation carriers.
authors.affiliation: *Division of Gynecology Oncology, Department of Obstetrics and Gynecology, and †Department of Surgery, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
authors.forename: Michael G
authors.initials: MG
authors.lastname: Moskoviz
authors.forename: Ron
authors.initials: R
authors.lastname: Auslender
authors.forename: Ofer
authors.initials: O
authors.lastname: Gemer
authors.forename: Arie
authors.initials: A
authors.lastname: Bitterman
authors.forename: Grace
authors.initials: G
authors.lastname: Younes
authors.forename: Yakir
authors.initials: Y
authors.lastname: Segev
mesh_terms: D000290:Adnexa Uteri / Q000473:pathology*; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000473:pathology*; D061325:Hereditary Breast and Ovarian Cancer Syndrome / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D033162:Incidental Findings; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D010052:Ovariectomy; D012189:Retrospective Studies