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999 Significance of complete embedding of risk-reducing salpingo-oophorectomy specimens in asymptomatic BRCA1/2 germline pathogenic variant carriers
  1. Iris AS Stroot1,
  2. Geertruida HDe Bock1,
  3. Harry Hollema1,
  4. Marise M Wagner1,
  5. HEBON Investigators2,
  6. Marian JE Mourits1 and
  7. Joost Bart1
  1. 1University Medical Centre Groningen, Groningen, The Netherlands
  2. 2Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating Centre: Netherlands Cancer Institute, Amsterdam, The Netherlands

Abstract

Introduction/Background We evaluated the effect of complete embedding of risk-reducing salpingo-oophorectomy (RRSO) specimens on detecting histopathological abnormalities in the RRSO specimen and the development of high-grade serous carcinoma (HGSC) after RRSO in BRCA1/2-germline pathogenic variant (GPV) carriers.

Methodology Included were RRSO specimens of asymptomatic BRCA1/2-GPV carriers from the Hereditary Breast and Ovarian cancer in the Netherlands (HEBON) cohort, who underwent RRSO between 1995 and 2018. Pathology reports were retrieved from the Dutch pathology registry (PALGA). Completely embedded specimens were compared to partially embedded specimens for presence of STIC/HGSC at RRSO and for development of HGSC after RRSO with Fisher’s exact test and using logistic and Cox regression analyses, adjusted for age at RRSO. Tissue slides of RRSO specimens with (pre)malignancy and from women who developed HGSC after RRSO were reviewed, to confirm the diagnosis of serous tubal intra-epithelial carcinoma (STIC) or HGSC.

Results For the 2557 included RRSOs, 1497 (58.5%) were completely embedded, which increased in the more recent years. After histopathological review, 8 isolated STICs (0.3%) and 30 HGSCs (1.2%) were found at RRSO. For the 2527 women with normal RRSO, median follow-up after RRSO was 13.8 years for BRCA1-GPV carriers and 12.9 years for BRCA2-GPV carriers. During follow up, 19 women (0.8%) developed HGSC after normal RRSO. The probability of finding a STIC/HGSC at RRSO was higher in completely embedded RRSOs, compared to partially embedded RRSOs (2.1 vs 0.7%, p=<0.001). Women with a completely embedded RRSO had a lower risk of developing HGSC during follow-up compared to women with a partially embedded RRSO (0.3 vs 1.4%, p=<0.001). Both results remained significant after adjusting for age at RRSO (OR=3.7 and HR=0.2).

Conclusion Complete embedding of RRSO specimens increases the detection of STIC and HGSC at RRSO, and is associated with a lower risk of developing HGSC in the years after RRSO.

Disclosures The authors have no conflicts of interest to disclose.

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