EP173/#392 High-grade serous carcinoma in risk-reducing salpingo-oophorectomy specimens of asymptomatic carriers of a BRCA1/2 germline pathogenic variant. (4th December 2022)

• Record Type: Journal Article
• Authors: Stroot, Iris; Brouwer, Jan; Bart, Joost; Hollema, Harry; Rookus, Matti; Wagner, Marise; Investigators, Hebon; Bock, Geertruida De; Mourits, Marian
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A118
• Page End: A118
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.264
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: We investigated the prevalence and reproductive and clinical factors associated with high-grade serous carcinoma (HGSC) at risk-reducing salpingo-oophorectomy (RRSO) in asymptomatic BRCA1/2 germline pathogenic variant (gPV) carriers. Methods: BRCA1/2 gPV carriers who underwent RRSO between 1995 and 2018 were identified in the Hereditary Breast and Ovarian cancer in the Netherlands (HEBON) study. Pathology reports were screened and RRSO specimens with any reported epithelial abnormality and of women with HGSC after normal RRSO were histologically reviewed. Clinical characteristics of women with and without HGSC at RRSO were compared to estimate the association between risk factors and HGSC at RRSO. Results: 2557 women of which 1624 BRCA1, 930 BRCA2 and 3 women with both BRCA1/2 gPV, were included. Median age at time of RRSO was 43.0 years (range: 25.3–73.8) for BRCA1 gPV carriers and 46.8 years (range: 27.6–77.9) for BRCA2 gPV carriers. At RRSO 24 (1.5%) BRCA1 and 6 (0.6%) BRCA2 gPV carriers had HGSC. In 73.3% the primary site of HGSC was the fallopian tube. For both BRCA1 gPV and BRCA2 gPV carriers, older age at RRSO was associated with an increased risk of HGSC at RRSO, while long-term use of oral contraceptive pill (OCP) was protective. Conclusions: HGSC was detected in 1.5% (BRCA1 gPV) and 0.6% (BRCA2 gPV) of RRSO specimens from asymptomatic carriers, with most HGSC lesions found in the fallopian tube. Our results support the fallopian tube hypothesis, highlight the importance of timely RRSO and total removal of fallopian tubes and show protective effects of OCP on HGSC.