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09. Prevention of gynaecologic cancer
1287 Preneoplastic lesions in BRCA mutated patients undergoing prophylactic bilateral salpingo-oophorectomy: an observational study
  1. Roberta Gallo1,
  2. Angelina Pernazza2,
  3. Camilla Turetta1,
  4. Flavia Adotti3,
  5. Federica Tomao4,
  6. Giuseppe Caruso5,
  7. Giorgia Perniola6,
  8. Laura De Marchis7,
  9. Violante Di Donato8 and
  10. Innocenza Palaia9
  1. 1Department of Gynecological, Obstetrical and Urological Sciences, ’Sapienza’ University of Rome, Rome, Italy, Rome, Italy
  2. 2Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy, Rome, Italy
  3. 3Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy, Rome, Italy
  4. 4Department of Gynecological, Obstetrical and Urological Sciences, ’Sapienza’ University of Rome, Rome, Italy, Roma, Italy
  5. 5Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, USA
  6. 6Department of Gynecological, Obstetrical and Urological Sciences, ’Sapienza’ University of Rome, Rome, Italy, Rome, Italy, Roma, Italy
  7. 7Sapienza University of Rome, Roma, Italy
  8. 8Department of Gynecological, Obstetrical and Urological Sciences, ’Sapienza’ University of Rome, Italy, Rome, Italy
  9. 9Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy

Abstract

Introduction/Background Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Among EOC, high-grade serous histotype (HGSOC) has high malignancy potential and strong association with BRCA mutations. Currently, the prevailing theory about the genesis of HGSOC is that it arises from the fimbriated end of the fallopian tube, which can present histopathological features considered precursor lesions, as serous tubal intraepithelial carcinoma (STIC). Recently, interest has grown on the frequency of STIC in BRCA-mutated population. The aim of the present study is to describe the incidence of STIC in BRCAm patients and to understand possible new clinical implications.

Methodology Twenty-eight women with BRCA1/2 germline mutation underwent risk-reducing salpingo oophorectomy (RRSO) between January 2020 and June 2023 at the Maternal-Child and Urological-Sciences Department of Policlinico Umberto I, ’Sapienza’ University of Rome, and were included in the study. Patients diagnosed with histologically proven gynecological cancer were excluded. Histopathological characteristics and immunohistochemical staining were evaluated. The following entities were diagnosed: p53 signature, STIL, STIC. The incidence of tubal preneoplastic lesions, risk and protective factors were evaluated.

Results Among the 28 patients, the mutational status was: 17(61%)BRCA1, 2(7%)BRCA1+BRCA2, 9(32%)BRCA2. Preoperatively, CA125 was within normal ranges in all patients. The overall incidence of lesions was 6/28(21%) (3 p53 signature, 1 STIL, 2 STIC). No statistically significant association between the diagnosis of preneoplastic lesions and type of mutation, breast cancer, smoking, comorbidities, some gynecological and obstetrical clinical condition (history of endometriosis, fibroids, pelvic inflammatory disease, cesarean section, parity) were found. None of the patients developed a malignant neoplasm of the peritoneum after surgery, with median follow-up of 26 months.

Conclusion Histopathological alteration can be found after RRSO. It would be appropriate to define the management and follow-up. Larger studies and longer follow up are needed to better understand the meaning of this clinical condition and establish a common clinical approach.

Disclosures No disclosures.

https://doi.org/10.1136/ijgc-2024-ESGO.918

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