Fallopian Tube and Primary Peritoneal Carcinomas Associated With <i>BRCA</i> Mutations

Levine, Douglas A.; Argenta, Peter A.; Yee, Cindy J.; Marshall, David; Olvera, Narciso; Bogomolniy, Faina; Rahaman, Jamal; Robson, Mark E.; Offit, Kenneth; Barakat, Richard R.; Soslow, Robert A.; Boyd, Jeff

doi:10.1200/jco.2003.04.131

Cited by 200 publications

(94 citation statements)

References 47 publications

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“…Six BRCA2 mutation carriers are found in 22 cases of PPSC by Levine et al (2003), but whether these cases developed after a prophylactic procedure is not mentioned. Clearly, it is too early to conclude that BRCA2 carriers face a lower risk than BRCA1 carriers of developing PPSC.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up

et al. 2004

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A retrospective study was performed to assess the histopathologic findings in high-risk women undergoing bilateral prophylactic (salpingo)-oophorectomy. The medical files of BRCA1 or BRCA2 mutation carriers and members of a hereditary breast/ovarian cancer (HBOC) family, who had undergone prophylactic surgery, were reviewed. In all, 38 women underwent a bilateral oophorectomy (26 BRCA1, three BRCA2 and nine HBOC, respectively). A total of 90 women underwent bilateral salpingooophorectomy (58 BRCA1, six BRCA2, one BRCA1 and 2, 25 HBOC, respectively). At the time of salpingo-oophorectomy, five of 58 BRCA1 carriers (8.6%) were diagnosed with an occult carcinoma: two fallopian tube carcinomas, two ovarian carcinomas and one case was defined as a fallopian tube/ovarian carcinoma. No occult carcinomas were found in the other groups. Of the 38 patients, who underwent a bilateral oophorectomy (mean follow-up 45 months), three of 26 BRCA1 mutation carriers (3.4 in 100 womenyears) developed peritoneal papillary serous carcinoma (PPSC) during follow-up. So far, no PPSC have occurred in the 90 women, who underwent a salpingo-oophorectomy (mean follow-up 12 months), including 58 BRCA1 carriers (0 in 60 in women-years). These results contribute to the thesis that BRCA1 germline mutation carriers are not only at risk for ovarian cancer, but also for fallopian tube carcinoma and peritoneal papillary serous carcinoma. Our data suggest that PPSC risk among BRCA2 carriers is lower than among BRCA1 carriers.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up

et al. 2004

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“…44 However, other series of tubal cancers have not shown a difference in frequency of BRCA mutations between tubal and ovarian cancers. [45][46][47] The Fimbria as a Preferred Site for Early Serous Carcinomas Because the fallopian tube is a major site of early cancer development in a group traditionally at risk for ovarian cancer (BRCA+), investigators must revise their perceptions of the origin(s) of pelvic serous cancer. Although it is conceivable that BRCA+ women are more prone to fallopian tube carcinomas than those without a family history, investigators hypothesized that the high frequency of tubal carcinoma in the BRCA+ population signified the tube as a more frequent site of origin than previously suspected.…”

Section: Lessons From the Brca Populationmentioning

confidence: 99%

Lessons from BRCA: The Tubal Fimbria Emerges as an Origin for Pelvic Serous Cancer

Crum¹,

Drapkin²,

Kindelberger³

et al. 2007

Clinical Medicine & Research

312

219

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Ovarian epithelial cancer is diagnosed in approximately 25,000 women yearly in the United States, accounting for approximately 12,500 deaths. Of these tumors, serous cancer is the most lethal, due to its capacity to spread beyond the reproductive tract and involve the peritoneal surfaces or distant organs. Conventional classification systems designate tumor origins principally on the location of the largest tumor. However, despite the fact that the largest tumors typically involve the ovaries, demonstrations of a precise starting point for these tumors, including precursor lesions, have been inconsistent. In recent years, a major effort to prevent serous cancer in genetically susceptible women with mutations in BRCA1 or BRCA2 has spawned the practice of prophylactic salpingo-oophorectomy. This practice has surprisingly revealed that many early cancers in these women arise in the fallopian tube, and further studies have pinpointed the distal (fimbrial) portion as the most common site of origin. Emerging studies that carefully examine the fallopian tubes suggest a high frequency of early cancer in the fimbria in unselected women with ovarian and peritoneal serous carcinoma, raising the distinct possibility that a significant proportion of these tumors have a fimbrial origin.The evidence for these discoveries and their relevance to serous cancer classification, early detection and prevention are addressed in this review. A model for pelvic serous cancer is proposed that takes into account five distinct variables which ultimately impact on origin and tumor distribution: (1) location of target epithelium, (2) genotoxic stress, (3) type of epithelium, (4) mitigating genetic factors, and (5) tumor spread pattern. Ultimately, this model illustrates the importance of identifying cancer precursors, inasmuch as these entities are useful as both surrogate endpoints for their respective malignancies in epidemiologic studies and natural targets for cancer prevention. Ovar ian epithelial cancer is diagnosed in approximately 25,000 women yearly in the United States with approximately one half dying of their disease. 1 It typically afflicts women near to menopause or postmenopause and peaks in the sixth to seventh decades of life. Surgery and chemotherapy will produce a complete response in 70% of patients; however, relapse rates are high, often occurring after a relatively brief respite. Overall long-term survival, but not cure, rates have only begun to improve measurably with the advent of taxol chemotherapy and intraperitoneal routes of instillation. However, the incremental gain in disease-free survival seen with these new therapies is only a few months. 2 Approximately 10% of women with ovarian cancer have a positive family history and most have an inherited heterozygous mutation in the BRCA1 or BRCA2 gene. Women with a hereditary predisposition for ovarian cancer develop the disease on average a decade earlier. 3,4 The lifetime risk of ovarian cancer in women with mutations in BRCA1 or BRCA2 (BRCA+) is estimated to be as h...

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“…Various studies have linked mutations in the BRCA1 and BRCA2 genes to PFTC [2][3][4], and alterations in p53 have been shown to be common in the disease; it has been suggested that these alterations may reduce survival [5,6]. Advanced stage [7,8], age [7], and the presence of residual tumor after initial surgery [7] have also been associated with decreased survival.…”

Section: Introductionmentioning

confidence: 99%

The incidence of primary fallopian tube cancer in the United States

Stewart

Wike²,

Foster

et al. 2007

Gynecologic Oncology

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Objective. The objective of this study was to report the incidence of primary fallopian tube carcinoma (PFTC) in the United States population and to describe associated demographic and clinical factors.Methods. A total of 3051 PFTC cases diagnosed from 1998 to 2003, reported from population-based cancer registries, were analyzed. Registries contributing data represent 83.1% of the U.S. population. Data are presented by age, race/ethnicity, U.S. census region, stage, histology, grade, and laterality. Trends in incidence over time from 1998 to 2003 are also presented.Results. The incidence rate was 0.41 per 100,000 women from 1998 to 2003. White, non-Hispanic women and women aged 60-79 had the highest incidence rates ( p b 0.0001). The majority (88%) of PFTCs were adenocarcinomas; serous adenocarcinomas accounted for 44% and endometrioid adenocarcinomas for 19% of adenocarcinoma diagnoses. Essentially half (49.9%) of PFTCs were poorly differentiated; 89% were unilateral at diagnosis. Stage at diagnosis was fairly evenly distributed among localized (36%), regional (30%), and distant (32%). Overall, rates of PFTC remained stable over time. Among women aged 65-69, incidence rates increased significantly by 3.8% per year from 1998 to 2003 ( p b 0.05).Conclusions. This report provides characteristics of PFTC using the largest number of cases assembled in one study to date. Although the demographic characteristics of PFTC are similar to those of ovarian cancer, stage at diagnosis and the stable trend observed in PFTC are in contrast to ovarian cancer. Future studies should focus on examining the increasing trend of PFTC among 65-to 69-year-old women. Published by Elsevier Inc.

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Fallopian Tube and Primary Peritoneal Carcinomas Associated With BRCA Mutations

Cited by 200 publications

References 47 publications

Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up

Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up

Lessons from BRCA: The Tubal Fimbria Emerges as an Origin for Pelvic Serous Cancer

The incidence of primary fallopian tube cancer in the United States

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