Our Summary

This research paper discusses a specific type of cancer called serous tubal intraepithelial carcinoma, which is often found as a precursor to another type of cancer. This cancer can be found in people at both low and high risk for cancer. It is particularly found in about 2% of patients with BRCA1/2 mutations who undergo a preventative surgery to remove their ovaries and fallopian tubes. However, even after this surgery, there is still a 7.5% chance of developing another form of cancer.

There is currently no clear guideline on what to do after this type of cancer is found during surgery. Some options include surgical staging, chemotherapy, or simple observation. The paper suggests that if this type of cancer is found, the patient should be referred for genetic testing for the BRCA1/2 mutations, as this could indicate a higher risk of hereditary cancer.

FAQs

  1. What is serous tubal intraepithelial carcinoma and who is at risk?
  2. What is the prevalence of serous tubal intraepithelial carcinomas in patients with BRCA1/2 mutations undergoing risk-reducing bilateral salpingo-oophorectomy?
  3. What are the postoperative recommendations after finding incidental serous tubal intraepithelial carcinomas?

Doctor’s Tip

A doctor might tell a patient undergoing salpingo-oophorectomy to discuss with their healthcare provider the possibility of genetic testing for BRCA1/2 mutations if incidental findings of serous tubal intraepithelial carcinoma (STIC) are discovered during the procedure. This can help determine the patient’s risk for developing primary peritoneal carcinoma and guide postoperative recommendations for further monitoring or treatment.

Suitable For

Salpingo-oophorectomy may be recommended for patients with a family history of ovarian or breast cancer, those with BRCA1/2 mutations, and those with a history of serous tubal intraepithelial carcinoma. Additionally, patients with a high risk of developing ovarian cancer, such as those with Lynch syndrome or a personal history of breast cancer may also be recommended for salpingo-oophorectomy.

Timeline

Before Salpingo-Oophorectomy:

  • Patient undergoes genetic testing to determine if they have BRCA1/2 mutations
  • Patient may undergo risk-reducing bilateral salpingo-oophorectomy if they are at high risk for developing ovarian or fallopian tube cancer
  • Surgery is performed to remove both fallopian tubes and ovaries

After Salpingo-Oophorectomy:

  • Pathology report reveals the presence of serous tubal intraepithelial carcinoma (STIC)
  • Patient is referred to a hereditary cancer program for further genetic testing for BRCA1/2 mutations
  • Treatment options such as surgical staging, adjuvant chemotherapy, or observation are discussed
  • Patient may be at risk for developing primary peritoneal carcinoma even after removal of the tubes and ovaries
  • Postoperative recommendations for managing incidental STICs remain unclear

What to Ask Your Doctor

  1. What is the reason for recommending a salpingo-oophorectomy in my case?
  2. What are the potential risks and complications associated with the procedure?
  3. How will the procedure affect my hormone levels and menopausal symptoms?
  4. What are the potential long-term effects of having my fallopian tubes and ovaries removed?
  5. How will the surgery affect my fertility and options for preserving fertility?
  6. How often will I need follow-up appointments and monitoring after the surgery?
  7. What are the chances of finding any abnormal cells or precancerous lesions during the surgery?
  8. If an incidental finding of serous tubal intraepithelial carcinoma (STIC) is discovered during the surgery, what are the recommended next steps?
  9. Should I consider genetic testing for BRCA1/2 mutations based on the presence of STIC?
  10. Are there any lifestyle changes or preventive measures I should consider after the surgery to reduce my risk of developing primary peritoneal carcinoma?

Reference

Authors: Patrono MG, Corzo C, Iniesta M, Ramirez PT. Journal: Clin Obstet Gynecol. 2017 Dec;60(4):771-779. doi: 10.1097/GRF.0000000000000316. PMID: 28957950