Title:
Risk-Reducing Salpingo-Oophorectomy: A Series of 90 BRCA1 and BRCA2 Mutation Carriers and Literature Review

Authors:
Vanesa Rodríguez-Fernández, MD; Lucía Cameselle-Cortizo, MD; Laura González Rodríguez, MD; Elena Figueiredo-Alonso, MD; María José Lamas González, MD; Javier Valdés-Pons, MD, Jorge F Cameselle-Teijeiro MD., Spain

Abstract:

As long as we do not have an effective screening routine, risk-reducing salpingo-oophorectomy (RRSO) is considered the gold standard for ovarian, fallopian, and primary peritoneal cancer prevention in women with documented BRCA1/2 mutations or other mutations with increased risk of ovarian cancer. Our objective was to review the pathological findings of RRSO in BRCA mutations carriers in order to estimate the prevalence of occult ovarian/tubal carcinoma. We studied a series of 90 women BRCA1/2 mutation carriers, with or without previous breast cancer, who underwent RRSO in the hospitals of our health area of Vigo. In our series, 4 women (4.4%) were diagnosed with malignant lesions in the fallopian epithelium (all of them in early stages). The main predictor for detecting occult malignancy in women at high risk for ovarian cancer who are going to undergo RRSO is to adhere to the surgical-pathological protocol. However, we must always bear in mind that there will always be a residual risk of primary peritoneal carcinoma after RRSO (1.1% in our series). We emphasize the importance of performing a germ line testing for all women diagnosed with epithelial ovarian/fallopian/peritoneal cancer (NCCN Guidelines). Our data support the indication for RRSO in selected high-risk patients; and recall the importance of the identification of high-risk patients, in order to offer genetic counseling and preventive measures, both for patients and their families

DOI: http://dx.doi.org/10.51505/ijmshr.2021.5212