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Outcomes of Incidental Fallopian Tube High-Grade Serous Carcinoma and Serous Tubal Intraepithelial Carcinoma in Women at Low Risk of Hereditary Breast and Ovarian Cancer
  1. Wen Yee Chay, MBBS, MRCP*,,
  2. W. Glenn McCluggage, MD, FRCPath,
  3. Cheng-Han Lee, MD, PhD§,
  4. Martin Köbel, MD,
  5. Julie Irving, MD, FRCPC,
  6. Joanne Millar, MD#,
  7. C. Blake Gilks, MD, FRCPC** and
  8. Anna V. Tinker, MD, FRCPC*
  1. *Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada;
  2. National Cancer Centre Singapore, Singapore;
  3. Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom;
  4. §Department of Laboratory Medicine and Pathology, Royal Alexandra Hospital, University of Alberta, Edmonton;
  5. Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta;
  6. Department of Pathology, Royal Jubilee Hospital and the University of British Columbia, Victoria, British Columbia, Canada;
  7. #Department of Oncology, NI Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom; and
  8. **Department of Pathology, Vancouver General Hospital and the University of British Columbia, Vancouver, British Columbia, Canada.
  1. Address correspondence and reprint requests to Anna V. Tinker, MD, FRCPC, Department of Medical Oncology, British Columbia Cancer Agency, 600 West 10th Ave, and the University of British Columbia, Vancouver, British Columbia, Canada V5Z4E6. E-mail: ATinker@bccancer.bc.ca.

Abstract

Objectives The natural history and optimal management of serous tubal intraepithelial carcinoma (STIC), regardless of BRCA status, is unknown. We report the follow-up findings of a series of incidental fallopian tube high-grade serous carcinomas (HGSCs) and STICs identified in women at low risk for hereditary breast and ovarian cancer (HBOC), undergoing surgery for other indications.

Materials and Methods Cases of incidental STIC and HGSC were identified from 2008. Patients with known BRCA1 or BRCA2 mutations, or a family history of ovarian or breast cancer before the diagnosis of STIC or HGSC were excluded. A retrospective chart review was conducted to obtain clinical data.

Results Eighteen cases were identified with a median follow-up of 25 months (range, 4–88 months). Twelve of 18 patients had a diagnosis of STIC with no associated invasive HGSC and 6 had STIC associated with other invasive malignancies. Completion staging surgery was performed on 7 of the 18 patients, including 5 of 12 in which there was STIC only identified on primary surgery; 3 cases were upstaged from STIC only to HGSC based on the staging surgery. Recurrence of HGSC occurred in 2 of the 18 patients. BRCA testing was performed on 3 patients, 1 of whom tested positive for a pathogenic BRCA1 mutation.

Conclusions Our study suggests that completion staging surgery for incidental STICs in non-BRCA patients may be considered. These patients should be offered hereditary testing. The Pelvic-Ovarian cancer INTerception (POINT) Project is an international registry set up to add to our understanding of STICs.

  • Serous tubal intraepithelial carcinoma (STIC)
  • Prophylactic salpingo-oophorectomy
  • Hereditary breast and ovarian syndromes

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Footnotes

  • The authors declare no conflicts of interest.

  • Institutional Ethics board approval was obtained for this study.

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