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
{"title":"Ovarian/Tubal Pathology in Premenopausal Women with Breast Cancer: A Prospective Study.","authors":"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","doi":"10.1007/s13224-024-02019-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"113-120"},"PeriodicalIF":0.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085504/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynecology of India","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13224-024-02019-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/31 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
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.
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