The majority of BRCA gene mutation carriers are supportive of offering PGD to others, thus endorsing the HFEA decision. However, most women would not consider it personally. Concerns raised highlight the need for regular HFEA reviews of the licensing criteria, as HBOC may cease to be a "serious life threatening illness" in the future.

Purpose: Patients with synchronous ovarian and endometrial cancers may represent cases of a single primary tumor with metastasis (SPM) or dual primary tumors (DP).The diagnosis given will influence the patient's treatment and prognosis. Currently, a diagnosis of SPM or DP is made using histologic criteria, which are frequently unable to make a definitive diagnosis. Experimental Design: In this study, we used genetic profiling to make a genetic diagnosis of SPM or DP in 90 patients with synchronous ovarian/endometrial cancers.We compared genetic diagnoses in these patients with the original histologic diagnoses and evaluated the clinical outcome in this series of patients based on their diagnoses. Results: Combining genetic and histologic approaches, we were able make a diagnosis in 88 of 90 cases, whereas histology alone was able to make a diagnosis in only 64 cases. Patients diagnosed with SPM had a significantly worse survival than patients with DP (P = 0.002). Patients in which both tumors were of endometrioid histology survived longer than patients of other histologic subtypes (P = 0.025), and patients diagnosed with SPM had a worse survival if the mode of spread was from ovary to endometrium rather than from endometrium to ovary (P = 0.019). Conclusions: Genetic analysis may represent a powerful tool for use in clinical practice for distinguishing between SPM and DP in patients with synchronous ovarian/endometrial cancer and predicting disease outcome. The data also suggest a hitherto uncharacterized level of heterogeneity in these cases, which, if accurately defined, could lead to improved treatment and survival.

We demonstrated that tumours of patients with platinum resistant EOC exhibit higher levels of VEGF expression compared to the platinum sensitive group. VEGF in EOC, may be of clinical and therapeutic relevance and suggests a role for first line anti-angiogenic therapy.

No abstract

Lynch syndrome is an autosomal dominant syndrome accounting for 2-5% of all colorectal cancer. In addition, women with Lynch syndrome have a substantially increased risk of developing endometrial cancer particularly pre-menopausally when symptom detection is more difficult. Current recommendations are that screening for endometrial cancer be offered to women identified to be at risk. The aim of the study was to assess the relative patient acceptability of the available screening modalities. A survey of the perception of the associated pain or discomfort associated with different screening modalities was conducted. Transvaginal ultrasonography was associated with less discomfort than hysteroscopy or Pipelle biopsy, and would be the single test of choice for the majority. There was no significant difference between the pain scores for hysteroscopy and Pipelle biopsy. Issues relating to test acceptability specific to this population are described. Patient acceptability of screening modalities should form an integral part of studies assessing the effectiveness of endometrial screening in the Lynch syndrome population.