Our Summary

The research paper is about the risk of developing peritoneal carcinomatosis (PC), a type of cancer that affects the peritoneum (the tissue lining the abdomen), in women who carry BRCA1/2 gene mutations. These mutations increase the risk of breast and ovarian cancer. Some women with these mutations choose to have their ovaries and fallopian tubes removed (a procedure known as risk-reducing salpingo-oophorectomy, or RRSO) to reduce their risk of ovarian cancer. However, they still have a small risk of developing PC.

The researchers wanted to understand whether having a certain type of lesion in the fallopian tubes, known as serous tubal intraepithelial carcinoma (STIC), affects this risk. They analyzed data from 17 studies, involving 3,121 women, and found that women with the BRCA1/2 mutation and STIC lesions were about 34 times more likely to develop PC than women with the mutation but no STIC lesions.

In practical terms, this meant that 10.5% of women with STIC developed PC within five years of their RRSO procedure, and 27.5% developed it within ten years. This compared to a risk of 0.3% and 0.9% respectively for women without STIC.

The researchers concluded that women carrying BRCA1/2 mutations who also have STIC lesions are at a significantly higher risk of developing PC, and this risk increases over time. However, they also pointed out that their conclusions were based on a small number of cases and that more research is needed.

FAQs

  1. What is the risk of developing peritoneal carcinomatosis (PC) in women with BRCA1/2 gene mutations who have undergone risk-reducing salpingo-oophorectomy (RRSO)?
  2. Does the presence of serous tubal intraepithelial carcinoma (STIC) lesions affect the risk of developing PC in women with BRCA1/2 mutation?
  3. What is the correlation between the time period post-RRSO and the increased risk of developing PC in women with BRCA1/2 mutations and STIC lesions?

Doctor’s Tip

A doctor might tell a patient undergoing a salpingo-oophorectomy to discuss with their healthcare provider the potential risks associated with having a BRCA1/2 gene mutation and the presence of STIC lesions in the fallopian tubes. It is important for the patient to understand the increased risk of developing peritoneal carcinomatosis (PC) over time and to be vigilant about monitoring their health and discussing any symptoms with their healthcare provider. Additionally, the patient should follow up regularly with their healthcare provider for ongoing surveillance and screening to detect any potential signs of PC early.

Suitable For

Therefore, patients who are typically recommended salpingo-oophorectomy are women with BRCA1/2 gene mutations who are at high risk of developing ovarian cancer. Additionally, women who have been diagnosed with serous tubal intraepithelial carcinoma (STIC) lesions in their fallopian tubes are also recommended this procedure due to their increased risk of developing peritoneal carcinomatosis (PC). It is important for these patients to discuss the potential risks and benefits of salpingo-oophorectomy with their healthcare provider to make an informed decision about their treatment options.

Timeline

Before salpingo-oophorectomy:

  1. Women undergo genetic testing to determine if they carry BRCA1/2 gene mutations.
  2. Women may undergo counseling to discuss their options and the potential risks and benefits of RRSO.
  3. Women make the decision to undergo RRSO.
  4. Women undergo pre-operative evaluations and preparations for surgery.

After salpingo-oophorectomy:

  1. Women undergo the surgical procedure to remove their ovaries and fallopian tubes.
  2. Women may experience post-operative pain, discomfort, and recovery time.
  3. Women may experience menopausal symptoms due to the removal of their ovaries.
  4. Women may undergo follow-up appointments and screenings to monitor for any potential complications or signs of cancer recurrence.
  5. Women with BRCA1/2 mutations and STIC lesions may be at a higher risk of developing PC, and may require additional monitoring and surveillance.

What to Ask Your Doctor

  1. What is a salpingo-oophorectomy and why is it recommended for women with BRCA1/2 mutations?
  2. What is serous tubal intraepithelial carcinoma (STIC) and how does it impact the risk of developing peritoneal carcinomatosis (PC)?
  3. What are the risks and benefits of undergoing a risk-reducing salpingo-oophorectomy (RRSO) for women with BRCA1/2 mutations?
  4. What are the potential long-term consequences of having a salpingo-oophorectomy, particularly in relation to the development of PC?
  5. Are there any alternative risk-reducing strategies for women with BRCA1/2 mutations that may lower the risk of developing PC?
  6. How often should women with BRCA1/2 mutations and STIC lesions undergo follow-up screenings or monitoring for PC?
  7. Are there any specific symptoms or signs that women should watch out for that may indicate the development of PC after undergoing a salpingo-oophorectomy?
  8. What are the current recommendations for managing the risk of PC in women with BRCA1/2 mutations and STIC lesions based on the latest research findings?
  9. Are there any ongoing clinical trials or research studies investigating new approaches or treatments for managing the risk of PC in this high-risk population?
  10. What steps can women take to optimize their overall health and well-being after undergoing a salpingo-oophorectomy, particularly in light of the increased risk of developing PC?

Reference

Authors: Steenbeek MP, van Bommel MHD, Bulten J, Hulsmann JA, Bogaerts J, Garcia C, Cun HT, Lu KH, van Beekhuizen HJ, Minig L, Gaarenstroom KN, Nobbenhuis M, Krajc M, Rudaitis V, Norquist BM, Swisher EM, Mourits MJE, Massuger LFAG, Hoogerbrugge N, Hermens RPMG, IntHout J, de Hullu JA. Journal: J Clin Oncol. 2022 Jun 10;40(17):1879-1891. doi: 10.1200/JCO.21.02016. Epub 2022 Mar 18. PMID: 35302882