Risk-Reducing Salpingo-Oophorectomy in Women With a BRCA1 or BRCA2 Mutation

Kauff, Noah D.; Satagopan, Jaya M.; Scheuer, Lauren; Hensley, Martee L.; Hudis, Clifford A.; Ellis, Nathan A.; Boyd, Jeff; Borgen, Patrick I.; Barakat, Richard R.; Norton, Larry; Offit, Kenneth

doi:10.1097/00006254-200209000-00016

Cited by 370 publications

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“…It has been shown that BSO in carriers of BRCA1 and BRCA2 mutations reduces the risk of developing malignancy of the coelomic epithelium by up to 96%, although some series have found a slightly lower risk reduction, and it is estimated that BSO reduces the risk of breast carcinoma by approximately 50% in premenopausal BRCA1 and BRCA2 mutation carriers. 36,37 A protective effect of tamoxifen in the 50% range against contralateral breast carcinoma has been observed in both BRCA1 carriers and BRCA2 carriers, although a question remains about the ability of tamoxifen to reduce the risk of hormone receptor-negative tumors that often are associated with BRCA1. 5,38 Thirty-six point six percent of the current cohort consisted of women who had their risk reduced before their initial screen.…”

Section: Discussionmentioning

confidence: 99%

Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma

Hartman

Daniel

Kurian

et al. 2004

Cancer

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Surface tension and viscosity are the important properties of liquid binders affecting wet granulation processes. They could be used to control solids flow pattern and relative motion of particles for controlling wetting, granule growth, consolidation, and breakage. This study aims to investigate experimentally the impacts of the two properties with a conical high shear granulator. The results show significant effects of viscosity and surface tension on solids flow pattern and relative motion of particles. The relative importance of the two parameters, the surface tension and the viscosity, are found to vary with the axial and radial positions in the granulator. For example, the viscosity force decreases with an increase in the bed height in the axial direction (vertical plane). The viscosity force between particles coated with PEG4000 solution is in mN order, whereas that between particles coated with ethanol and water is in μN order. © 2009 American Institute of Chemical Engineers AIChE J, 2009

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Section: Discussionmentioning

confidence: 99%

Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma

Hartman

Daniel

Kurian

et al. 2004

Cancer

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“…[101][102][103] RRBSO is now considered the optimal risk-management strategy for this population of high-risk women. [19][20][21][22] Choosing RRBSO appears to be related to older age, perceived cancer risk, and perceived benefit of surgery. [99][100][101][104][105][106] In a 2012 long-term outcome study, Schwartz et al observed that >80% of BRCA1/BRCA2 carriers had undergone RRM, or RRBSO, or both at approximately 5 years after testing.…”

Section: Hbocmentioning

confidence: 99%

“…In addition, for BRCA1/BRCA2 carriers, risk-reducing bilateral salpingo-oophorectomy (RRBSO) is recommended after the completion of childbearing to decrease the risk of both ovarian cancer and breast cancer, and they also are offered the option of risk-reducing bilateral mastectomy (RRM). [19][20][21][22] Individuals who have HNPCC-related mutations have a similarly high lifetime risk of developing colon cancer of approximately 25% to 75% and an approximately 30% to 70% risk of developing endometrial cancer. 23 Individuals with Lynch syndrome also are predisposed to other cancers, such as urothelial cancers, small bowel cancer in men, and breast cancer in women.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric implications of cancer genetic testing

Hirschberg

Chan‐Smutko

Pirl

2014

Cancer

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As genetic testing for hereditary cancer syndromes has transitioned from research to clinical settings, research regarding its accompanying psychosocial effects has grown. Men and women being tested for hereditary cancer syndromes may experience some psychological distress while going through the process of testing or after carrier status is identified. Psychological distress appears to decrease over the course of the first year and it is typically not clinically significant. Longer term studies show mixed results with some mutation carriers continuing to experience elevated distress. Baseline distress is the greatest risk factor for both immediate (weeks-12 months) and long-term psychological distress (18 mo-8 years post genetic testing). In addition to baseline psychological distress, other risk factors can be identified to help identify individuals who may need psychosocial interventions during the genetic testing process. The challenges of providing clinical care to the growing population of individuals identified to be at increased risk for heritable cancers present opportunities for research and new models of care. Cancer 2015;121:341-60. V C 2014 American Cancer Society.KEYWORDS: BRCA1, BRCA2, HNPCC, Lynch syndrome, genetic testing, unaffected carrier, carrier, hereditary cancer syndrome, riskreducing surgeries, psychosocial. INTRODUCTIONSeveral familial cancer syndromes that confer a high lifetime risk of cancer can be identified with genetic testing, and greater numbers of men and women will consider testing as the availability and public awareness of genetic testing for cancer susceptibility continue to increase. Research to date suggests that these individuals will have varied emotional responses to the process of genetic testing as well as its results.When genetic testing for cancer syndromes first transitioned from research protocols to clinics, there was initial concern that it would be similar to genetic testing for Huntington disease. Many worried that knowing they are at high risk for cancer in the future may be too distressing for some individuals, possibly even leading to suicide. However, several systematic reviews focusing primarily on hereditary breast and ovarian cancer (HBOC) and Lynch syndrome, also known as hereditary nonpolyposis colon cancer (HNPCC), have demonstrated that most individuals who have a mutation identified in an associated gene cope well with the knowledge of their genetic status. 1-3 Data regarding psychological implications of the genetic testing process are the most robust for women who present for HBOC risk assessment, which involves discussion of the BRCA1 and BRCA2 genes, although there are increasing studies for HNPCC, familial adenomatous polyposis (FAP), and other hereditary cancer syndromes.Although the rates of distress in individuals undergoing genetic testing vary, they appear to be relatively small. Studies have demonstrated that approximately 6% to 24% of individuals undergoing genetic testing for a BRCA1/BRCA2-associated or HNPCC-associated mutations repo...

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“…Several studies have reported that the incidence of breast cancer declines in women with BRCA1 or BRCA2 mutations following an oopohorectomy Kauff et al, 2002;Eisen et al, 2005). In the largest of these, Eisen et al (2005) performed a casecontrol study on 1439 BRCA mutation carriers with breast cancer, and 1866 matched controls without breast cancer.…”

Section: Oophorectomymentioning

confidence: 99%

Modifiers of risk of hereditary breast cancer

Narod

2006

Oncogene

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Mutations in the BRCA1 and BRCA2 genes confer a high lifetime risk of breast and ovarian cancer. The risk varies from individual to individual, and it appears that the risk has increased in recent generations. These observations imply that non-genetic factors may modify the inherited risk. To date, the factors that appear most strongly to modify the risk include reproductive histories and exogenous hormones. Oral contraceptives are associated with a profound reduction in the risk of ovarian cancer, and with little or no increase in the risk of breast cancer. Other modifying factors include age of menarche, parity, breastfeeding and oophorectomy. The effect of parity is different in BRCA1 and BRCA2 carriers. Multiparity appears to be protective in BRCA1 carriers, but is associated with an increase in risk in BRCA2 carriers. Oophorectomy has been associated with reductions in both the risk of breast and ovarian cancer. Knowledge of these risk factors will be useful for managing risk and for developing prevention strategies.

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Risk-Reducing Salpingo-Oophorectomy in Women With a BRCA1 or BRCA2 Mutation

Cited by 370 publications

References 0 publications

Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma

Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma

Psychiatric implications of cancer genetic testing

Modifiers of risk of hereditary breast cancer

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