Objective Our study aimed to evaluate the incidence of pathological findings in asymptomatic Korean patients with BRCA1/2 pathogenic variants who underwent risk-reducing salpingo-oophorectomy and to assess their long-term prognosis.
Methods We retrospectively analyzed the medical records of patients with a germinal BRCA1/2 pathologic variant who had undergone risk-reducing salpingo-oophorectomy at Asan Medical Center (Seoul, Korea) between January 2013 and December 2020. All pathologic reports were made based on the sectioning and extensively examining the fimbriated end of the fallopian tube (SEE/FIM) protocol.
Results Out of 243 patients who underwent risk-reducing salpingo-oophorectomy, 121 (49.8%) had a BRCA1 mutation, 119 (48.9%) had a BRCA2 mutation, and three (1.2%) had both mutations. During the procedure, four (3.3%) patients with a BRCA1 mutation were diagnosed with serous tubal intraepithelial carcinoma (STIC) or serous tubal intraepithelial lesion (STIL), and another four patients (3.3%) were diagnosed with occult cancer despite no evidence of malignancy on preoperative ultrasound. In the BRCA2 mutation group, we found one (0.8%) case of STIC, but no cases of STIL or occult cancer. During the median follow-up period of 98 months (range, 44–104) for STIC and 54 months (range, 52–56) for STIL, none of the patients diagnosed with these precursor lesions developed primary peritoneal carcinomatosis.
Conclusions Risk-reducing salpingo-oophorectomy, in asymptomatic Korean patients with BRCA1/2 pathogenic variants, detected ovarian cancer and precursor lesions, including STIC or STIL. Furthermore, our follow-up period did not reveal any instances of primary peritoneal carcinomatosis, suggesting a limited body of evidence supporting the imperative need for adjuvant treatment in patients diagnosed with these precursor lesions during risk-reducing salpingo-oophorectomy.
- Fallopian Tube Neoplasms
- BRCA1 Protein
- BRCA2 Protein
Data availability statement
No data are available.
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Contributors Author responsible for the overall content as the guarantor: L-SW Concept and design: K-OJ, L-SW, K-YM. Acquisition, analysis, or interpretation of data: K-OJ, L-SW, K-YM, K-JH, P-JY, S-DS, K-DY, K-JH. Drafting of the manuscript: K-OJ, L-SW, K-YM. Critical revision of the manuscript for important intellectual content: K-OJ, L-SW, K-YM. Statistical analysis: K-OJ, LSW. Administrative, technical, or material support: L-SW, K-YM, K-JH, P-JY, S-DS, K-DY, K-JH, K-YT. Supervision: K-YM, K-YT.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.