Prophylactic risk-reducing salpingo-oophorectomy in BRCA mutation carriers: what is going on in a region of northern Italy?
BRCA
Breast cancer survivor
Hysterectomy
Ovarian cancer
Prophylactic, pathology
Risk-reducing salpingo-oophorectomy
Journal
Maturitas
ISSN: 1873-4111
Titre abrégé: Maturitas
Pays: Ireland
ID NLM: 7807333
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
17
04
2020
revised:
07
08
2020
accepted:
24
08
2020
entrez:
14
12
2020
pubmed:
15
12
2020
medline:
17
2
2021
Statut:
ppublish
Résumé
BRCA1 mutation carriers are recommended to undergo prophylactic risk-reducing salpingo-oophorectomy (RRSO) between the ages of 35 and 40 or when child bearing is complete, with a possible delay until age 40-45 for BRCA2 mutation carriers. Primary outcome was the rate of unsuspected cancer findings during RRSO in a region of northern Italy (Emilia Romagna) and secondary outcomes were details of RRSO: age at surgical intervention, the venue of the procedures in relation to the surgical/pathological quality and the rate/role of concomitant opportunistic hysterectomies. Multicentre data collection by invitation to report current RRSO practices. A total of 222 RRSOs (54.5 % BRCA1, 34.7 % BRCA2, 1.8 % BRCA1 and BRCA2 combined, 5.8 % BRCA-VUS and 3.2 % BRCA not better specified) were reported from 9 different centres, half in non-university hospitals and the remainder in university hospitals. Breast cancer survivors (56.3 %) underwent the RRSO at a younger age (47.8 vs 50.6 years, p = 0.02). The mean and median ages at surgical intervention (49.0 and 48.0, respectively) were similar for BRCA1 and BRCA2 mutation carriers, as was the temporal trend in age distribution, and proportions treated in university and non-university hospitals. A diagnosis of ovarian invasive cancer was reported in 3.5 % of subjects, all BRCA1 or BRCA-combined subjects, at a median and mean age of 57 years (range 42-68). Abnormal tubal findings, such as serous tubal intraepithelial lesions (STIL) (100 %), secretory cell outgrowth (SCOUT) (100 %) and STIC (71.4 %), were mainly reported by pathologists in university hospitals. Of the 222 procedures, 15 (6.7 %) included hysterectomies: in none of these cases was a primitive uterine endometrioid or serous cancer found. The results from this multicentre regional study should guide future preventive health policies for RRSO in BRCA mutation carriers.
Sections du résumé
BACKGROUND
BACKGROUND
BRCA1 mutation carriers are recommended to undergo prophylactic risk-reducing salpingo-oophorectomy (RRSO) between the ages of 35 and 40 or when child bearing is complete, with a possible delay until age 40-45 for BRCA2 mutation carriers.
STUDY QUESTION
OBJECTIVE
Primary outcome was the rate of unsuspected cancer findings during RRSO in a region of northern Italy (Emilia Romagna) and secondary outcomes were details of RRSO: age at surgical intervention, the venue of the procedures in relation to the surgical/pathological quality and the rate/role of concomitant opportunistic hysterectomies.
STUDY DESIGN
METHODS
Multicentre data collection by invitation to report current RRSO practices.
RESULTS
RESULTS
A total of 222 RRSOs (54.5 % BRCA1, 34.7 % BRCA2, 1.8 % BRCA1 and BRCA2 combined, 5.8 % BRCA-VUS and 3.2 % BRCA not better specified) were reported from 9 different centres, half in non-university hospitals and the remainder in university hospitals. Breast cancer survivors (56.3 %) underwent the RRSO at a younger age (47.8 vs 50.6 years, p = 0.02). The mean and median ages at surgical intervention (49.0 and 48.0, respectively) were similar for BRCA1 and BRCA2 mutation carriers, as was the temporal trend in age distribution, and proportions treated in university and non-university hospitals. A diagnosis of ovarian invasive cancer was reported in 3.5 % of subjects, all BRCA1 or BRCA-combined subjects, at a median and mean age of 57 years (range 42-68). Abnormal tubal findings, such as serous tubal intraepithelial lesions (STIL) (100 %), secretory cell outgrowth (SCOUT) (100 %) and STIC (71.4 %), were mainly reported by pathologists in university hospitals. Of the 222 procedures, 15 (6.7 %) included hysterectomies: in none of these cases was a primitive uterine endometrioid or serous cancer found.
CONCLUSIONS
CONCLUSIONS
The results from this multicentre regional study should guide future preventive health policies for RRSO in BRCA mutation carriers.
Identifiants
pubmed: 33308637
pii: S0378-5122(20)30361-3
doi: 10.1016/j.maturitas.2020.08.011
pii:
doi:
Substances chimiques
BRCA1 Protein
0
BRCA1 protein, human
0
BRCA2 Protein
0
BRCA2 protein, human
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
59-64Investigateurs
Lorenzo Aguzzoli
(L)
Valentina Arcangeli
(V)
Roberto Berretta
(R)
Laura Cortesi
(L)
Roberta De Domenico
(R)
Maria De Nuzzo
(M)
Stefano Friso
(S)
Pantaleo Greco
(P)
Federica Rosati
(F)
Gennaro Scutiero
(G)
Angela Toss
(A)
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.