Ovarian/Tubal Pathology in Premenopausal Women with Breast Cancer: A Prospective Study.

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY
Sahana Punneshetty, Sherin Daniel, Shawn Thomas, Ajit Sebastian, Selvamani, Ashish Singh, Aaron Chapla, Sumita Danda, M J Paul, Anitha Thomas, Abraham Peedicayil, Rachel G Chandy
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引用次数: 0

Abstract

Introduction: Breast cancer is most common cancer among women and hereditary mutations account for 5-10%. HBOC syndrome is most common hereditary mutation affecting breast & ovary. The prevalence of STIC lesions in these women ranges from 2 to 12% and that in general population is unknown. Role of risk reduction salpingo-oophorectomy (RRSO) is well established among these women. Surgical ovarian ablation also plays role in hormone positive breast cancers in prolonging their survival by permanent hormone suppression. The role of oophorectomy has different impacts in breast cancer.

Methodology: The study aimed to determine the different indications for oophorectomy and their histologies among premenopausal breast cancer women. This was a prospective cross sectional study of breast cancer women diagnosed ≤ 50 years of age. All these women underwent genetic counselling, gynaecology examination, transvaginal scan &CA 125 testing. Surgery was offered to women with BRCA mutations (RRSO) and also for hormone receptor positive women (surgical ovarian ablation). Histopathologies of these women were analysed using SEE-FIM protocol.

Results: A total of 98 breast cancer women were identified. The median age was 41.5 years (SD 5.7) & median CA 125 was 9.3 (IQR 6-20.5). The genetic acceptance rate was 18%. Four patients were germline BRCA 1/2 positive, 1 VUS, 13 negative and 80 didn't opt for test. Ultrasound imaging showed cystic ovaries among 12 patients. Most of them had benign features. Twenty two patients underwent surgery (bilateral salpingo-oophorectomy)-3 BRCA positive and rest for hormone positive breast cancer. Histopathologies were normal except for Krukenberg's mets in one hormone positive breast cancer patient.

Conclusion: The incidence of germline mutations in our study was 5%. STIC lesions were not detected in our study, attributing to low acceptance of genetic testing. The value of screening for ovarian cancer was limited. Incorporation of genetics into routine gynaecology oncology clinic needs further addressal. Our study opened the doors for the genetic awareness among these young women.

绝经前妇女乳腺癌的卵巢/输卵管病理:一项前瞻性研究。
乳腺癌是女性中最常见的癌症,遗传突变占5-10%。HBOC综合征是影响乳腺和卵巢最常见的遗传突变。这些妇女中STIC病变的患病率在2%到12%之间,在一般人群中的患病率尚不清楚。输卵管卵巢切除术(RRSO)降低风险的作用在这些妇女中得到了很好的证实。卵巢手术消融术也在激素阳性乳腺癌中发挥作用,通过永久性激素抑制延长其生存期。卵巢切除术对乳腺癌的作用有不同的影响。方法:本研究旨在确定绝经前乳腺癌妇女卵巢切除术的不同适应症及其组织学。这是一项针对诊断年龄≤50岁的乳腺癌女性的前瞻性横断面研究。所有这些妇女都接受了遗传咨询、妇科检查、经阴道扫描和ca125检测。BRCA突变女性(RRSO)和激素受体阳性女性(卵巢切除手术)均可接受手术。使用SEE-FIM协议分析这些妇女的组织病理学。结果:共有98名乳腺癌女性被确诊。中位年龄为41.5岁(SD 5.7),中位ca125为9.3 (IQR 6-20.5)。基因接受率为18%。生殖系BRCA 1/2阳性4例,VUS 1例,阴性13例,80例未选择检测。12例超声示卵巢囊肿。他们中的大多数都是良性的。手术(双侧输卵管-卵巢切除术)22例,3例BRCA阳性,其余为激素阳性乳腺癌。除了一名激素阳性乳腺癌患者的Krukenberg转移外,组织病理学正常。结论:本研究中种系突变发生率为5%。由于基因检测的接受度较低,在我们的研究中未检测到STIC病变。卵巢癌筛查的价值是有限的。将遗传学纳入常规妇科肿瘤学临床需要进一步解决。我们的研究为这些年轻女性的基因意识打开了大门。
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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
124
期刊介绍: Journal of Obstetrics and Gynecology of India (JOGI) is the official journal of the Federation of Obstetrics and Gynecology Societies of India (FOGSI). This is a peer- reviewed journal and features articles pertaining to the field of obstetrics and gynecology. The Journal is published six times a year on a bimonthly basis. Articles contributed by clinicians involved in patient care and research, and basic science researchers are considered. It publishes clinical and basic research of all aspects of obstetrics and gynecology, community obstetrics and family welfare and subspecialty subjects including gynecological endoscopy, infertility, oncology and ultrasonography, provided they have scientific merit and represent an important advance in knowledge. The journal believes in diversity and welcomes and encourages relevant contributions from world over. The types of articles published are: ·         Original Article·         Case Report ·         Instrumentation and Techniques ·         Short Commentary ·         Correspondence (Letter to the Editor) ·         Pictorial Essay
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