Abstract
Pathogenic germline mutations of BRCA1/2 confer predisposition to breast and ovarian cancer. Herein, we report the clinical outcomes in monozygotic twins with ovarian cancer carrying a deleterious BRCA1 mutation. While one of the twins with the deleterious mutation underwent an operation and chemotherapy for ovarian cancer at the age of 47 years, the other underwent risk-reducing salpingo-oophorectomy (RRSO) at the age of 48 years to decrease the risk of ovarian cancer from the same mutation. Pathological examination revealed no evidence of neoplasia in the bilateral salpinx and ovaries. The factors that increase the risk of ovarian cancer, including age at menarche, condition of menstruation, body mass index, contraceptive use, hormone therapies, smoking, alcohol use, and exercise habits, were similar between these twins. However, the one who underwent RRSO was married, had delivered at 40 weeks of gestation, and breast-fed for 1.5 years, unlike the other. Therefore, parity and lactation may be the most important factors in decreasing the risk for ovarian cancer, especially in monozygotic twins carrying a deleterious BRCA1 mutation.
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