Clinical findings and medical management of hereditary breast-ovarian cancer without molecular diagnosis in a referral cancer center.

Abstract

e15527 Background: Ovarian cancer is the leading cause of death from gynecologic malignancies. Women at high risk of hereditary breast and/or ovarian cancer (HBOC) require specific management strategies. The goal of this study was to determine the prevalence of HBOC among patients in a referral cancer center. To analyze the pathologic and clinical characteristics of HBOC and examine whether survival is influenced by family history of breast or ovarian cancer. Methods: This retrospective study included all epithelial ovarian cancers seen at the National Cancer Institute of México from 2000-2009. Epidemiological and clinical variables were collected from the patients' medical records. Results: In 1071 cases, we found 15 patients with HBOC. The first pathology was breast cancer, and the ovarian cancer was diagnosed in average 8.23 years later. Only in 2 patients the ovarian cancer was before than breast cancer. The median age was 53 (35-69) years old at diagnosis for breast cancer and 51(40-75) years old in ovarian cancer. The advanced clinical stage was 13% for breast cancer versus 60% for the ovarian cancer. The histology was ductal carcinoma for breast cancer and serous papillary carcinoma for ovarian cancer with high grade. The recurrent disease was frequent for ovarian cancer. The median overall survival was 8 years (1-20 years). Conclusions: Recognition of when ovarian cancer is a substantial risk (in BRCA1 and BRCA2 carriers) is essential. However, the appropriate intervention is difficult to judge, and careful balancing is needed.