Prophylactic surgery and ovarian cancer treatment of women carriers of BRCA 1 gene mutation

Abstract

e22139 Backgrounds. Tree BRCA 1 mutations commonly present in Polish population (5382 insC, C61G, 4153 delA) have been implicated in familial clustering of mammary-ovarian cancer. Prophylactic bilateral adnexectomy reduce the risk of ovarian cancer of more then 80% and the risk of brest cancer to 53%. Methods. It is retrospective study. We enrolled 193 women carriers of BRCA 1 mutation. 161 had prophylactic adnexectomy and 32 were treated because of diagnosed ovarian cancer. All were treated at our Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents between 1999–2008. We analysed the frequency of brest cancer in patients who were admitted to the hospital for prophylactic surgery and number of ovarian cancer diagnosed during prophylactic surgery. We analysed the response on standard treatment based on platinum analogs in carriers of BRCA 1 with ovarian cancer. It was also evaluated the incidence of primary peritoneal cancer in patients after prophylactic treatment. Results. The age of women at the time of prophylactic operation were between 41–60 y.o (mean 45 years old). We found, that 61 of patients had already diagnosed and were treated because of breast cancer (37.9%). During prophylactic surgery we diagnosed 10 cases of ovarian cancer, 2 cases of primary peritoneal cancer and 2 fallopian tubes cancer. These patients had no symptoms and were qualified to prophylactic adnexectomy. 32 women with ovarian cancer diagnosis had typical response to standard treatment, 70% were platinum sensitive and DFS was more then 12 months, 25 % had DFS between 6–12 months and 5% were platinum resistant. There were diagnosed only 2 cases of primary peritoneal cancer in patients after 31 and 61 months from prophylactic treatment. Conclusions. Separation the risk group - patients carriers BRCA 1 mutation let us to introduce effective prophylactic rules of conduct. No significant financial relationships to disclose.