Regarding “The Role of Routine Peritoneal and Omental Biopsies at Risk-reducing Salpingo-oophorectomy”

Abstract

We read with interest the paper by Miller et al published in the July–August 2017 issue of JMIG [ 1 Miller H. Pipkin L.S. Tung C. Hall T.R. Masand R.P. Anderson M.L. The role of routine peritoneal and omental biopsies at risk-reducing salpingo-oophorectomy. J Minim Invasive Gynecol. 2017; 24: 772-776 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar ]. The authors observed that peritoneal staging is not useful in patients undergoing risk-reduction surgery due to the presence of a deleterious mutation of BRCA1 and BRCA2 genes. In a study based on the sample size of 70 patients, they observed that no patients were diagnosed with occult carcinoma thanks to the execution of peritoneal staging (including washing and omental and peritoneal biopsies) per se [ 1 Miller H. Pipkin L.S. Tung C. Hall T.R. Masand R.P. Anderson M.L. The role of routine peritoneal and omental biopsies at risk-reducing salpingo-oophorectomy. J Minim Invasive Gynecol. 2017; 24: 772-776 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar ]. In this study, the rate of unexpected lesions was 4.2% (including 3 cases of serous tubal intraepithelial carcinoma [STIC]) [ 1 Miller H. Pipkin L.S. Tung C. Hall T.R. Masand R.P. Anderson M.L. The role of routine peritoneal and omental biopsies at risk-reducing salpingo-oophorectomy. J Minim Invasive Gynecol. 2017; 24: 772-776 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar ]. Actually, even though this procedure is considered preventative, occult malignancies have been diagnosed in 2%–17% of cases across different series [ 1 Miller H. Pipkin L.S. Tung C. Hall T.R. Masand R.P. Anderson M.L. The role of routine peritoneal and omental biopsies at risk-reducing salpingo-oophorectomy. J Minim Invasive Gynecol. 2017; 24: 772-776 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar , 2 Soliman P.T. Should we perform routine peritoneal and staging biopsies at the time of risk-reducing bilateral salpingo-ophrectomy?. J Minim Invasive Gynecol. 2017; 24: 691 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar , 3 Bogani G. Tagliabue E. Signorelli M. et al. Assessing the risk of occult cancer and 30-day morbidity in women undergoing risk-reducing surgery: a prospective experience. J Minim Invasive Gynecol. 2017; 24: 837-842 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar , 4 Powell C.B. Kenley E. Chen L.M. et al. Risk-reducing salpingo-oophorectomy in BRCA mutation carriers: role of serial sectioning in the detection of occult malignancy. J Clin Oncol. 2005; 23: 127-132 Crossref PubMed Scopus (324) Google Scholar ]. The Role of Routine Peritoneal and Omental Biopsies at Risk-Reducing Salpingo-OophorectomyJournal of Minimally Invasive GynecologyVol. 24Issue 5PreviewTo assess the potential role of peritoneal and omental biopsies in women undergoing risk-reducing salpingo-oopherectomy (RRSO) for prophylactic management of hereditary breast/ovarian cancer (HBOC) syndromes. Full-Text PDF Author's ReplyJournal of Minimally Invasive GynecologyVol. 24Issue 7PreviewWe thank Dr. Bogani and his coauthors for their interest in our recently published article [1]. Given that as many as 3.9% of women undergoing risk-reducing salpingo-oopherectomy (RRSO) for high-risk mutations in BRCA1/2 ultimately develop primary peritoneal carcinoma (PPC), we concur that efforts to identify those women are worthwhile [2,3]. Full-Text PDF