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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Outcome of risk-reducing salpingo-oophorectomy in BRCA carriers and women of unknown mutation status
BJOG: An International Journal of Obstetrics and Gynaecology, Volume 118, No. 7, Year 2011
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Description
Objective To compare surgical outcomes and occult cancer rates at risk-reducing salpingo-oophorectomy in BRCA carriers and high-risk women who had not undergone genetic testing. Design Prospective cohort study. Setting Tertiary high-risk familial gynaecological cancer clinic. Population Women undergoing risk-reducing salpingo-oophorectomy between January 2005 and November 2009. Methods Women at high-risk of ovarian/tubal cancer were identified on the basis of the inclusion criteria for the UK Familial Ovarian Cancer Screening Study. Risk management options discussed with 1456 high-risk women included risk-reducing salpingo-oophorectomy. A strict histopathological protocol with serial slicing was used to assess tubes and ovaries. Results In total, 308 high-risk women (191 with unknown mutation status; 117 known BRCA1/BRCA2 carriers) chose risk-reducing surgery; 94.5% of procedures were performed laparoscopically. The surgical complication rate was 3.9% (95% CI 2.0-6.7). Four ovarian and ten tubal occult invasive/in situ cancers were found. The overall occult invasive cancer rate was 5.1% (95% CI 1.9-10.83) in BRCA1/BRCA2 carriers and 1.05% (95% CI 0.13-3.73) in untested women. When tubal in situ cancers were included, the overall rate was 4.55% (95% CI 2.5-7.5). Two untested women with tubal carcinoma in situ were subsequently found to be BRCA carriers. The median ages of BRCA carriers (58 years; IQR 13.4 years) and untested women (49.5 years; IQR 20.6 years) with occult invasive/in situ cancer were not significantly different (P = 0.454). Conclusions Both high-risk women of unknown mutation status and BRCA carriers have a significant (although higher in the latter group) rate of occult invasive/in situ tubal/ovarian cancer, with a similar age distribution at detection. The data has important implications for counselling high-risk women on the likelihood of occult malignancy and perioperative complications at risk-reducing salpingo-oophorectomy. Women with occult disease should be offered genetic testing. © 2011 RCOG.
Authors & Co-Authors
Manchanda, Ranjit
United Kingdom, London
University College London
Abdelraheim, Ahmed R.
United Kingdom, London
Barts and the London School of Medicine and Dentistry
Egypt, Minya
Al-minya University Hospital
Johnson, Michelle
United Kingdom, London
University College London
Rosenthal, Adam N.
United Kingdom, London
University College London
Benjamin, Elizabeth
United Kingdom, London
Ucl Cancer Institute
Brunell, Carol
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Burnell, Matthew
United Kingdom, London
University College London
Side, Lucy E.
United Kingdom, London
University College London
Gessler, S.
United Kingdom, London
University College London
Saridoǧan, Ertan
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Oram, D.
United Kingdom, London
Barts and the London School of Medicine and Dentistry
Jacobs, Ian J.
United Kingdom, London
University College London
Menon, Usha
United Kingdom, London
University College London
United Kingdom, London
Ucl Ega Institute for Women's Health
Statistics
Citations: 121
Authors: 13
Affiliations: 6
Identifiers
Doi:
10.1111/j.1471-0528.2011.02920.x
ISSN:
14700328
e-ISSN:
14710528
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Participants Gender
Female