title: Primary peritoneal cancer in BRCA carriers after prophylactic bilateral salpingo-oophorectomy.
abstract: OBJECTIVE
  The presence of deleterious mutations in breast cancer (BRCA)-1 or BRCA-2 gene has a decisive influence on the development of various types of neoplasms, such as breast, ovarian, tubal, and peritoneal cancers. Primary peritoneal cancer is an aggressive malignancy which, due to the absence of a specific screening test, cannot be diagnosed in its early stages. As a risk-reducing option, prophylactic bilateral salpingo-oophorectomy and mastectomy are often proposed in BRCA gene carriers. The effectiveness of a preventive surgical treatment is, however, unclear in the development of peritoneal cancer.
  
  
  METHODS
  An extensive electronic search was performed in PubMed, Scopus, and Cochrane databases.
  
  
  RESULTS
  The total number of patients who underwent prophylactic bilateral salpingo-oophorectomy was 1,830, of whom 28 presented with peritoneal cancer (1.53%). The age of the included patients ranged from 48 to 61 years. BRCA-1 was present in 9 out of 28 patients and BRCA-2 in 2 patients, while the type of BRCA was unclear in 17 patients. Salpingo-oophorectomy was performed in 23 out of 28 patients, while oophorectomy was carried out in 5 patients. The interval from initial risk-reducing surgical treatment to the presentation of peritoneal cancer ranged from 12 to 84 months.
  
  
  CONCLUSIONS
  Modification of the follow-up guidelines and increase in healthcare providers' awareness may reduce the risk of peritoneal cancer.
authors.affiliation: Gynaecological Oncology Department, Christie Hospital, Manchester, United Kingdom.
authors.forename: Christos
authors.initials: C
authors.lastname: Iavazzo
authors.affiliation: First Department of Surgery, General Hospital of Attica "KAT", Athens, Greece.
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Gkegkes
authors.affiliation: Second Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vrachnis
keywords: BRCA gene; etiology; management; peritoneal carcinoma; prophylaxis