Pathological findings and long-term prognosis in Korean BRCA1/2 mutation carriers undergoing risk-reducing salpingo-oophorectomy.

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  • Additional Information
    • Source:
      Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Electronic Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE
    • Publication Information:
      Publication: 2019- : [London] : BMJ
      Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991-
    • Subject Terms:
      Peritoneal Neoplasms*/epidemiology ; Fallopian Tube Neoplasms*/pathology ; Ovarian Neoplasms*/pathology ; Cystadenocarcinoma, Serous*/pathology; Female ; Humans ; Salpingo-oophorectomy ; BRCA1 Protein/genetics ; Ovariectomy ; Retrospective Studies ; BRCA2 Protein/genetics ; Mutation ; Prognosis ; Republic of Korea
    • Abstract:
      Objective: Our study aimed to evaluate the incidence of pathological findings in asymptomatic Korean patients with BRCA1/2 pathogenic variants who underwent risk-reducing salpingo-oophorectomy and to assess their long-term prognosis.
      Methods: We retrospectively analyzed the medical records of patients with a germinal BRCA1/2 pathologic variant who had undergone risk-reducing salpingo-oophorectomy at Asan Medical Center (Seoul, Korea) between January 2013 and December 2020. All pathologic reports were made based on the sectioning and extensively examining the fimbriated end of the fallopian tube (SEE/FIM) protocol.
      Results: Out of 243 patients who underwent risk-reducing salpingo-oophorectomy, 121 (49.8%) had a BRCA1 mutation, 119 (48.9%) had a BRCA2 mutation, and three (1.2%) had both mutations. During the procedure, four (3.3%) patients with a BRCA1 mutation were diagnosed with serous tubal intraepithelial carcinoma (STIC) or serous tubal intraepithelial lesion (STIL), and another four patients (3.3%) were diagnosed with occult cancer despite no evidence of malignancy on preoperative ultrasound. In the BRCA2 mutation group, we found one (0.8%) case of STIC, but no cases of STIL or occult cancer. During the median follow-up period of 98 months (range, 44-104) for STIC and 54 months (range, 52-56) for STIL, none of the patients diagnosed with these precursor lesions developed primary peritoneal carcinomatosis.
      Conclusions: Risk-reducing salpingo-oophorectomy, in asymptomatic Korean patients with BRCA1/2 pathogenic variants, detected ovarian cancer and precursor lesions, including STIC or STIL. Furthermore, our follow-up period did not reveal any instances of primary peritoneal carcinomatosis, suggesting a limited body of evidence supporting the imperative need for adjuvant treatment in patients diagnosed with these precursor lesions during risk-reducing salpingo-oophorectomy.
      Competing Interests: Competing interests: None declared.
      (© IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
    • Contributed Indexing:
      Keywords: BRCA1 Protein; BRCA2 Protein; Fallopian Tube Neoplasms; Surgery
    • Accession Number:
      0 (BRCA1 protein, human)
      0 (BRCA1 Protein)
      0 (BRCA2 protein, human)
      0 (BRCA2 Protein)
    • Publication Date:
      Date Created: 20230804 Date Completed: 20231108 Latest Revision: 20231108
    • Publication Date:
      20231108
    • Accession Number:
      10.1136/ijgc-2023-004618
    • Accession Number:
      37541685