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prophylactic oophorectomy

Paige E Tucker, Paul A Cohen
INTRODUCTION: Women with familial cancer syndromes such as hereditary breast and ovarian cancer syndrome (BRCA1 and BRCA2) and Lynch syndrome are at a significantly increased risk of developing ovarian cancer and are advised to undergo prophylactic removal of their ovaries and fallopian tubes at age 35 to 40 years, after childbearing is complete. METHODS: A comprehensive literature search of studies on risk-reducing salpingo-oophorectomy (RRSO), sexuality, and associated issues was conducted in MEDLINE databases...
March 23, 2017: International Journal of Gynecological Cancer
Roi Tschernichovsky, Annekathryn Goodman
OBJECTIVE: The objective of this study was to review the role of bilateral salpingo-oophorectomy in BRCA mutation (mBRCA) carriers and alternative interventions in risk reduction of ovarian cancer (OC). MATERIALS AND METHODS: A systematic review using PubMed, MEDLINE, EMBASE, and the Cochrane library was conducted to identify studies of different strategies to prevent OC in mBRCA carriers, including bilateral salpingo-oophorectomy, prophylactic salpingectomy with delayed oophorectomy, intensive surveillance, and chemoprevention...
March 17, 2017: Oncologist
Heather Miller, Laura S Pipkin, Celestine Tung, Tracilyn R Hall, Ramya P Masand, Matthew L Anderson
STUDY OBJECTIVE: Assess the potential role of peritoneal and omental biopsies in women undergoing risk-reducing salpingo-oopherectomy (RRSO) for prophylactic management of hereditary breast/ovarian cancer syndromes (HBOC). DESIGN: Retrospective observational cohort DESIGN: Classification: II.1 SETTING: Academic gynecology practice PATIENTS: All women who underwent RRSO for a high risk BRCA1/2 mutation or deletion at a single institution between January, 2003 and June, 2016...
March 8, 2017: Journal of Minimally Invasive Gynecology
Robin Irons, Erin McIntosh, Alexandre Hageboutros, David Warshal, Steven McClane
BACKGROUND: This case report draws attention to the debated role of prophylactic oophorectomy in women undergoing definitive surgical resection of colon and rectal cancers. It can be challenging to discern the indications and appropriate patient population for this procedure based on the current literature. Potential benefits include treatment and prevention of metastatic disease, preventing development of primary ovarian cancer, and prolonging survival. Negative effects include an increase in operative time and potential morbidity, development of osteoporosis, the risk of cardiac events, and decreasing sexual function...
February 7, 2017: World Journal of Surgical Oncology
Steven J Weissbart, Ariana L Smith
Hysterectomy is an important surgical procedure in the care of women with pelvic organ prolapse or lower urinary tract malignancy. Therefore, hysterectomy can be a commonly performed surgical procedure in the urologist's practice. Obtaining a thorough gynecologic history is necessary prior to performing a hysterectomy and prolapse repair. Specifically, reviewing prior cervical cancer screening, risk factors for uterine malignancy, and the role of prophylactic salpingo-oophorectomy are important steps of the reconstructive surgical planning process...
January 2017: Current Urology Reports
Rebecca Flyckt, Suejin Kim, Tommaso Falcone
Surgical approaches to endometriosis patients with chronic pelvic pain are multimodal and require individualization. Laparoscopic approaches are preferred over laparotomy when conservatively treating endometriosis via excision or ablation/fulguration of lesions. The available data support cystectomy over fenestration or fulguration for endometriomas; however, there may be associated decreases in ovarian reserve with endometrioma treatment. Presacral neurectomy may be useful in patients with midline pain and LUNA is not effective for the treatment of pelvic pain related to endometriosis...
January 2017: Seminars in Reproductive Medicine
Soley Bayraktar, Banu Arun
BRCA mutation carriers have a very high risk of breast and ovarian cancer by age 70, in the ranges 47%-66% and 40%-57%, respectively. Additionally, women with BRCA mutation-associated breast cancer also have an elevated risk of other or secondary malignancies. Fortunately, the breast and ovarian cancer outcome for BRCA1/2 mutation carriers is at least as good as for non-carriers with chemoprevention, prophylactic surgeries and appropriate use of therapies. Therefore, identification of those who might have a mutation is important so that genetic counseling, testing, screening and prevention strategies can be applied in a timely manner...
February 2017: Breast: Official Journal of the European Society of Mastology
Dana Johns, Jay Agarwal, Layla Anderson, Jian Ying, Wendy Kohlmann
BACKGROUND: BRCA1 and BRCA2 gene mutations carry with them a 50%-80% risk of developing breast cancer. The best choice for managing breast cancer risk in patients with a BRCA1/2 mutation is a highly personal decision. Options for risk management include surveillance with multiple modalities or prophylactic surgical intervention. The goal of this study was to gain a better understanding of contributing factors affecting the decision for managing breast cancer risk made by patients who are BRCA mutation positive and cancer free...
December 6, 2016: Journal of Women's Health
Kathleen M Sturgeon, Lorraine T Dean, Mariane Heroux, Jessica Kane, Toni Bauer, Erica Palmer, Jin Long, Shannon Lynch, Linda Jacobs, David B Sarwer, Mary B Leonard, Kathryn Schmitz
PURPOSE: The goal of this RCT was to examine the efficacy and safety of a web-based program to improve cardiovascular and bone health outcomes, among 35 BRCA1/2+ breast cancer survivors who underwent prophylactic oophorectomy and thus experienced premature surgical menopause. METHODS: A 12-month commercially available web-based lifestyle modification program (Precision Nutrition Coaching) was utilized. Cardiovascular fitness, dietary intake, leisure time activity, body composition, bone mineral density, bone structure, and muscle strength were assessed...
April 2017: Journal of Cancer Survivorship: Research and Practice
Ruth Heisey, June C Carroll
OBJECTIVE: To summarize the best evidence on strategies to identify and manage women with a family history of breast cancer. SOURCES OF INFORMATION: A PubMed search was conducted using the search terms breast cancer, guidelines, risk, family history, management, and magnetic resonance imaging screening from 2000 to 2016. Most evidence is level II. MAIN MESSAGE: Taking a good family history is essential when assessing breast cancer risk in order to identify women suitable for referral to a genetic counselor for possible genetic testing...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Kandice K Ludwig, Joan Neuner, Annabelle Butler, Jennifer L Geurts, Amanda L Kong
BACKGROUND: Mutations in BRCA1 or BRCA2 genes results in an elevated risk for developing both breast and ovarian cancers over the lifetime of affected carriers. General surgeons may be faced with questions about surgical risk reduction and survival benefit of prophylactic surgery. METHODS: A systematic literature review was performed using the electronic databases PubMed, OVID MEDLINE, and Scopus comparing prophylactic surgery vs observation with respect to breast and ovarian cancer risk reduction and mortality in BRCA mutation carriers...
October 2016: American Journal of Surgery
J Menkiszak, V Sopik, A Chudecka-Głaz, W Domagała, E Urasińska, H Symonowicz, E Majdanik, P Waloszczyk, K Sycz, M Świniarska, T Huzarski, C Cybulski, T Debniak, O Oszurek, J Lubinski, S A Narod, J Gronwald
The aim of the study was to evaluate the impact of a regional population-based genetic testing program on the incidence of ovarian cancer in West Pomerania. Between 1999 and 2010, a total of 37,552 women ages 35 to 70 were tested for three BRCA1 founder mutations at the outpatient genetics clinic of the Pomeranian Medical University in Szczecin, Poland. A total of 641 women were found to carry a mutation (1.7%) and of these, 220 had a prophylactic oophorectomy (34.3%). A total of 12 women had an occult cancer diagnosed at the time of prophylactic oophorectomy (5...
February 2017: Clinical Genetics
Joanne Kotsopoulos, Tomasz Huzarski, Jacek Gronwald, Christian F Singer, Pal Moller, Henry T Lynch, Susan Armel, Beth Karlan, William D Foulkes, Susan L Neuhausen, Leigha Senter, Nadine Tung, Jeffrey N Weitzel, Andrea Eisen, Kelly Metcalfe, Charis Eng, Tuya Pal, Gareth Evans, Ping Sun, Jan Lubinski, Steven A Narod
BACKGROUND: Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. METHODS: Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n = 3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable)...
January 2017: Journal of the National Cancer Institute
Karin Hellner, Fabrizio Miranda, Donatien Fotso Chedom, Sandra Herrero-Gonzalez, Daniel M Hayden, Rick Tearle, Mara Artibani, Mohammad KaramiNejadRanjbar, Ruth Williams, Kezia Gaitskell, Samar Elorbany, Ruoyan Xu, Alex Laios, Petronela Buiga, Karim Ahmed, Sunanda Dhar, Rebecca Yu Zhang, Leticia Campo, Kevin A Myers, María Lozano, María Ruiz-Miró, Sónia Gatius, Alba Mota, Gema Moreno-Bueno, Xavier Matias-Guiu, Javier Benítez, Lorna Witty, Gil McVean, Simon Leedham, Ian Tomlinson, Radoje Drmanac, Jean-Baptiste Cazier, Robert Klein, Kevin Dunne, Robert C Bast, Stephen H Kennedy, Bassim Hassan, Stefano Lise, María José Garcia, Brock A Peters, Christopher Yau, Tatjana Sauka-Spengler, Ahmed Ashour Ahmed
Current screening methods for ovarian cancer can only detect advanced disease. Earlier detection has proved difficult because the molecular precursors involved in the natural history of the disease are unknown. To identify early driver mutations in ovarian cancer cells, we used dense whole genome sequencing of micrometastases and microscopic residual disease collected at three time points over three years from a single patient during treatment for high-grade serous ovarian cancer (HGSOC). The functional and clinical significance of the identified mutations was examined using a combination of population-based whole genome sequencing, targeted deep sequencing, multi-center analysis of protein expression, loss of function experiments in an in-vivo reporter assay and mammalian models, and gain of function experiments in primary cultured fallopian tube epithelial (FTE) cells...
August 2016: EBioMedicine
Charles W Drescher, J David Beatty, Robert Resta, M Robyn Andersen, Kate Watabayashi, Jason Thorpe, Sarah Hawley, Hannah Purkey, Jessica Chubak, Nancy Hanson, Diana S M Buist, Nicole Urban
BACKGROUND: Guidelines recommend genetic counseling and testing for women who have a pedigree suggestive of an inherited susceptibility for ovarian cancer. The authors evaluated the effect of referral to genetic counseling on genetic testing and prophylactic oophorectomy in a randomized controlled trial. METHODS: Data from an electronic mammography reporting system identified 12,919 women with a pedigree that included breast cancer, of whom 625 were identified who had a high risk for inherited susceptibility to ovarian cancer using a risk-assessment questionnaire...
July 22, 2016: Cancer
F Guidozzi
Women with a BRCA1 or BRCA2 gene mutation have substantially higher risk for developing not only breast and ovarian cancers, but also for primary peritoneal, Fallopian tube, colonic, pancreatic cancers, uterine papillary serous adenocarcinoma and malignant melanoma. The risk for ovarian cancer ranges from 39 to 49% by 70 years of age in BRCA1 mutation carriers and from 11 to 18% for those with a BRCA2 mutation, whilst breast cancer increases similarly within women who have either the BRCA1 mutation or the BRCA2 mutation, from about 20% in women in their forties, 37% by the age of 50 years, 55% by 60 years and more than 70% by the age of 70 years...
October 2016: Climacteric: the Journal of the International Menopause Society
Christos Iavazzo, Ioannis D Gkegkes, Nikolaos Vrachnis
OBJECTIVE: The presence of deleterious mutations in breast cancer (BRCA)-1 or BRCA-2 gene has a decisive influence on the development of various types of neoplasms, such as breast, ovarian, tubal, and peritoneal cancers. Primary peritoneal cancer is an aggressive malignancy which, due to the absence of a specific screening test, cannot be diagnosed in its early stages. As a risk-reducing option, prophylactic bilateral salpingo-oophorectomy and mastectomy are often proposed in BRCA gene carriers...
2016: Journal of the Turkish German Gynecological Association
G Chene, B de Rochambeau, K Le Bail-Carval, E Beaufils, P Chabert, G Mellier, G Lamblin
OBJECTIVES: Since the recent evidence of a tubal origin of most ovarian cancers, opportunistic salpingectomy could be discussed as a prophylactic strategy in the general population and with hereditary predisposition. We aimed to survey French gynecological surgeons about their current surgical practice of prophylactic salpingectomy. METHODS: An anonymous online survey was sent to French obstetrician-gynaecologists and gynecological surgeons. There were 13 questions about their current clinical practice and techniques of salpingectomy during a benign hysterectomy or as a tubal sterilization method, salpingectomy versus salpingo-oophorectomy in the population with genetic risk, salpingectomy in relationship with endometriosis and questions including histopathological considerations...
July 2016: Gynécologie, Obstétrique & Fertilité
Steven Lehrer, Sheryl Green, Kenneth E Rosenzweig
BACKGROUND: High dose ionizing radiation can induce ovarian cancer, but the effect of low dose radiation on the development of ovarian cancer has not been extensively studied. We evaluated the effect of low dose radiation and total background radiation, and the radiation delivered to the ovaries during the treatment of rectosigmoid cancer and breast cancer on ovarian cancer incidence. MATERIALS AND METHODS: Background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States, 2011...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Andreas Obermair, Danny Youlden, Peter Baade, Monika Janda
AIM: Our previous population-based research found prophylactic surgery (hysterectomy and bilateral salpingo-oophorectomy [BSO]) halved the mortality risk for premenopausal breast cancer patients. Here we aim to replicate findings in a Western Australia dataset. METHOD: Data from the Western Australia Cancer Registry of 15 395 women 20-79 years diagnosed with primary breast cancer (1997-2011) was categorized into four groups: neither hysterectomy nor BSO, hysterectomy only, BSO only, or hysterectomy + BSO...
February 2017: Asia-Pacific Journal of Clinical Oncology
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